Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JOHN SCOTT BRODERICK, M.D.
ActiveDR. JOHN SCOTT BRODERICK, M.D. is a Clinical Neurophysiology healthcare provider located in MEQUON, Wisconsin. NPI 1508939976 is currently active in the NPPES registry. Verify at CMS.
Clinical Neurophysiology · MEQUON, WI
Registration Details
- NPI Number
- 1508939976
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Nov 15, 2006 (19.76262958857 yrs)
- Last Updated
- Jun 8, 2012
- License
-
46762-020 (WI)
Practice Information
- Address
-
13133 N PORT WASHINGTON RDSUITE G06MEQUON, WI, 530972419Browse WI providers · Browse ZIP 53097
- Phone
- 2622438371
- Fax
- 2622438342
- Primary Specialty
-
Clinical Neurophysiology
2084N0600X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.