Organization
PREMIER HEART ASSOCIATES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE T BRODERICK JR. MD (PRESIDENT)
(937) 832-2425
Entity
Organization
Contact information
Practice address
25 W HARDING RD, SPRINGFIELD, OH 45504-1396
(937) 832-2425
(937) 832-9804
Mailing address
9000 N MAIN ST, STE 101, DAYTON, OH 45415-1180
(938) 832-2425
(937) 832-9804
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2212117
—
OH
Enumeration date
02/06/2007
Last updated
10/12/2007
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