Individual
DR. MOLLY MAGGARD BROCKMAN
Active
Individual
DR. MOLLY MAGGARD BROCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52490
KY
208000000X
Pediatrics Physician
52490
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52490
MEDICAL LICENSE
KY
05
—
7100430860
—
KY
01
—
K310660
MEDICARE
KY
Enumeration date
03/30/2015
Last updated
02/09/2023
Update your record
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