Organization
BRODELL MEDICAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT T BRODELL MD (PRESIDENT)
(330) 393-4000
Entity
Organization
Contact information
Practice address
2660 E MARKET ST, WARREN, OH 44483-6204
(330) 393-4000
(330) 392-5870
Mailing address
2660 E MARKET ST, WARREN, OH 44483-6204
(330) 393-4000
(330) 392-5870
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35051453
OH
207W00000X
Ophthalmology Physician
35051515
OH
207W00000X
Ophthalmology Physician
35055185
OH
207W00000X
Ophthalmology Physician
35055186
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0583962
—
OH
Enumeration date
04/02/2007
Last updated
03/15/2011
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