GEORGE T BRODERICK (NPI# 1134125271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1134125271 |
Entity Type | Individual |
Full Name | GEORGE T BRODERICK |
Credential | MD |
Practice Address |
9000 N Main St Ste 101 Dayton OH 45415-1184 |
Practice Telephone | 9378322425 |
Practice Fax Number | 9378329804 |
Mailing Telephone | 9378322425 |
Mailing Fax Number | 9378329804 |
Enumeration Date | 2005-06-23 |
Last Update Date | 2013-03-14 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
35062694B | OH | Allopathic & Osteopathic Physicians |
Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
35062694B | OH | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OH | 0849863 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578625208 | George Steven Broderick | Psychiatry & Neurology | 5500 Verulam Ave, Cincinnati, OH 45213-2418 | 2006-12-16 |
Street Address |
9000 N MAIN ST STE 101 |
City | DAYTON |
State | OH |
Zip Code | 45415-1184 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164425443 | Abdelhamed I Abdelhamed | Internal Medicine | 9000 N Main St, Ste 101, Dayton, OH 45415-1180 | 2005-05-31 |
1952893299 | Alan Ayette | Pharmacy | 9000 N Main St, Mvhn Inpatient Pharmacy, Dayton, OH 45415 | 2018-06-02 |
1689165896 | Bonnie Homan Tangeman | Pharmacist | 9000 N Main St, Dayton, OH 45415-1180 | 2018-05-23 |
1275022709 | Karen Ann Hartman | Pharmacist | 9000 N Main St, Retail Pharmacy, Dayton, OH 45415 | 2018-05-10 |
1699177329 | Christopher Groff | Physician Assistant | 9000 N Main St, Ste 227, Dayton, OH 45415-1180 | 2014-09-25 |
1609297134 | Pfdental Reddy Inc | Dentist | 9000 N Main St, Ste 207, Dayton, OH 45415-1180 | 2013-12-31 |
1497190029 | Associated Foot and Ankle Specialists of Ohio Inc | Podiatrist | 9000 N Main St, Suite 203, Dayton, OH 45415-1180 | 2013-05-09 |
1518209618 | Samaritan Family Care Inc | Family Medicine | 9000 N Main St, Ste 238, Dayton, OH 45415-1180 | 2013-03-27 |
1912246034 | Samaritan Family Care, Inc | Surgery | 9000 N Main St, Dayton, OH 45415-1180 | 2013-02-08 |
1013272616 | Carla Renee King | Advanced Practice Midwife | 9000 N Main St, Suite 232, Dayton, OH 45415-1180 | 2012-07-10 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457881062 | Angelique Oluyitan | Registered Nurse | 50 Granite Dr, Dayton, OH 45415 | 2017-06-15 |
1255869244 | Sherry Marie Buchanan | Occupational Therapy Assistant | 140 Ewoodbury Dr, Dayton, OH 45415 | 2017-06-02 |
1417328972 | Thomas Riddell | Hearing Instrument Specialist | 5525 N. Main St, Dayton, OH 45415 | 2015-10-09 |
1932448537 | Mory Summer | General Practice | 141 Trailwoods Dr., Dayton, OH 45415 | 2013-02-04 |
1184909095 | Yolanda Jean Jenkins | Registered Nurse | 6339 Afton Drive, Dayton, OH 45415 | 2011-10-12 |
1023392560 | Megan E Betts | Specialist/Technologist, Other | 9000 N Main St. Ste 303, Dayton, OH 45415 | 2011-10-03 |
1356655195 | Gwendolyn L. Warren | Massage Therapist | 8393 N. Main St., Ste B, Dayton, OH 45415 | 2010-08-04 |
1811141559 | Dayton Physicians, LLC | Durable Medical Equipment & Medical Supplies | 9000 N Main St Suite 333, Dayton, OH 45415 | 2008-11-07 |
1730331224 | Joel Metze | Obstetrics & Gynecology | 9000 N Main St Ste 232, Englewood, OH 45415 | 2008-10-16 |
1023236247 | James Otis Hurst | Dentist | 9000 N. Main Street, Suite 207, Dayton, OH 45415 | 2007-04-23 |
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Taxonomy Code | 207RI0011X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Interventional Cardiology |
An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1871848309 | Brendan Anthony Korpanty | Internal Medicine | 4160 Little York Rd Ste 20, Dayton, OH 45414-5803 | 2012-07-20 |
1477827947 | Premier Health Specialists Inc | Internal Medicine | 9000 N Main St, Ste 101, Dayton, OH 45415-1180 | 2012-03-01 |
1093030827 | Anil H. Jhangiani Md LLC | Internal Medicine | 4172 Indian Ripple Rd, Suite B, Dayton, OH 45440-3285 | 2010-04-05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730799347 | Warren Endovascular Associates LLC | Internal Medicine | 1950 Niles Cortland Rd Ne Ste 12, Warren, OH 44484-1077 | 2020-08-07 |
1821570128 | Rishi Puri | Internal Medicine | 9500 Euclid Ave # J2-208, Cleveland, OH 44195-0001 | 2018-09-04 |
1760980049 | Cardiac Cin of Columbus LLC | Internal Medicine | 175 S 3rd St Ste 200-248, Columbus, OH 43215-5134 | 2018-01-31 |
1316445695 | Cardiac Cin of Cincinnati LLC | Internal Medicine | 9435 Waterstone Blvd Ste 140-302, Cincinnati, OH 45249-8226 | 2018-01-31 |
1720462591 | Midwest Access Services LLC | Internal Medicine | 7335 Yankee Rd Ste 101, Liberty Township, OH 45044-0008 | 2015-07-12 |
1306878863 | Medcentral Professional Association Inc. | Internal Medicine | 308 Glessner Ave, Mansfield, OH 44903-2225 | 2006-07-07 |
1629077961 | Gregory J Wood | Internal Medicine | 7200 Mentor Ave, Mentor, OH 44060-7522 | 2005-07-19 |
1508865213 | Joseph Michael Surmitis | Internal Medicine | 4082 Fulton Dr Nw, Canton, OH 44718-2866 | 2005-07-15 |
1851396428 | Puvi N Seshiah | Internal Medicine | 3219 Clifton Ave, Suite 400, Cincinnati, OH 45220-3027 | 2005-06-20 |
1669474839 | David G Bichsel | Internal Medicine | 745 W State St, Ste 750, Columbus, OH 43222-1515 | 2005-06-01 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.