Individual
STEPHAN BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 291-4000
Mailing address
5923 RENAISSANCE PL, TOLEDO, OH 43623-4709
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35.138719
OH
207P00000X
Emergency Medicine Physician
4351039441
MI
Other
Enumeration date
05/15/2017
Last updated
06/22/2020
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