DR. KRISTEN PARKER BRODERICK (NPI# 1891915021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891915021 |
| Entity Type | Individual |
| Full Name | DR. KRISTEN PARKER BRODERICK |
| Credential | MD |
| Practice Address |
4940 Eastern Ave Suite A520 Baltimore MD 21224-2735 |
| Practice Telephone | 4105500407 |
| Practice Fax Number | 4105501808 |
| Mailing Telephone | 4105500407 |
| Mailing Fax Number | 4105501808 |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2016-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
D0080874 | MD | Allopathic & Osteopathic Physicians |
| Street Address |
4940 EASTERN AVE SUITE A520 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21224-2735 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841295714 | Jerome M Shier | Allergy & Immunology | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2005-06-16 |
| 1740889609 | Haimanot Mulat | Nurse Practitioner | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-10-21 |
| 1457958704 | Ashley B Gemon | Student in an Organized Health Care Education/Training Program | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-10-08 |
| 1235756800 | Lauren Kerrigan | Nurse Practitioner | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-06-30 |
| 1568086692 | Kathleen Campbell Mckenzie | Physician Assistant | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-06-04 |
| 1639791197 | Sharice Cheng | Physician Assistant | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-05-07 |
| 1679194799 | John Donald Giles | Nurse Practitioner | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-04-29 |
| 1598386971 | Meiyappan Udayappan | Student in an Organized Health Care Education/Training Program | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-04-27 |
| 1972123370 | Molly Elizabeth Maresca Atwood | Psychologist | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-04-26 |
| 1982224887 | Ofure Anita Akhiwu | Student in an Organized Health Care Education/Training Program | 4940 Eastern Ave, Baltimore, MD 21224-2735 | 2020-04-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710595517 | Lisa Farinelli | Registered Nurse | 251 Bayview Bldv, Baltimore, MD 21224 | 2020-07-17 |
| 1891303038 | Lorenzo Leggio | General Practice | Nih/nida, Bayview Campus, Brc, 251 Bayview Boulevard, Room 01a844, Baltimore, MD 21224 | 2020-07-14 |
| 1922622737 | Johns Hopkins Bayview Medical Center, Inc. | Community/Behavioral Health | 5500 E. Lombard Street, Room 1025, Baltimore, MD 21224 | 2020-06-08 |
| 1558995670 | Myeong Hyun Chae | Dentist | 7839 Eastern Ave, Baltimore, MD 21224 | 2020-02-27 |
| 1720627581 | Johns Hopkins Bayview Medical Center, Inc. | Clinic/Center | 5500 East Lombard Street, Room 1025, Baltimore, MD 21224 | 2019-12-27 |
| 1194288431 | Tawny Meagan Epperson | Counselor | 5500 E Lombard Street, Community Psychiatry, Child Mobile Treatment Services, Baltimore, MD 21224 | 2019-04-12 |
| 1437613163 | Johns Hopkins University | Internal Medicine | 5210 Eastern Avenue, Alpha Center, Baltimore, MD 21224 | 2019-01-28 |
| 1669993606 | Maria Giannas | Pharmacist | 6510 O'donnell St, Baltimore, MD 21224 | 2017-06-29 |
| 1588193437 | Heather Ann Sand | Social Worker | 1501 S Clinton Street, Mailstop Ct 05-13, Baltimore, MD 21224 | 2017-06-05 |
| 1912447822 | Jennifer Ann Maser Hermann | Counselor | 4637 Hudson Street, Baltimore, MD 21224 | 2017-02-27 |
| Find all providers in zip 21224 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043509748 | Salih Colakoglu | Surgery | 601 N Caroline St # 8152c, Baltimore, MD 21287-0006 | 2011-04-04 |
| 1962822684 | Alexander Chase Castillo | Surgery | 227 Saint Paul St, Baltimore, MD 21202-2001 | 2014-04-21 |
| 1225463821 | Greater Baltimore Plastic and Hand Surgery Associates, LLC | Surgery | 6569 N Charles St, Suite 706, Baltimore, MD 21204-6831 | 2013-09-13 |
| 1497981914 | Arthur Jung Nam | Surgery | 22 S Greene St, Baltimore, MD 21201-1544 | 2009-06-10 |
| 1689874398 | Branko Bojovic | Surgery | 22 S Greene St, Baltimore, MD 21201-1544 | 2007-07-20 |
| 1649498163 | Baltimore Center for Facial Plastic Surgery | Surgery | 6535 N Charles St, Baltimore, MD 21204-5826 | 2007-04-22 |
| 1891816112 | William Gilbert Armiger | Surgery | 1421 S Caton Ave, Suite 203, Baltimore, MD 21227-1025 | 2007-04-03 |
| 1417093410 | Brendan Joseph Collins | Surgery | 301 Saint Paul Pl, Plastic and Reconstructive Surgery, Mercy Med. Center, Baltimore, MD 21202-2102 | 2007-01-29 |
| 1831118892 | Facial Plastic Surgicenter | Surgery | 1838 Greene Tree Rd, Ste 370, Baltimore, MD 21208 | 2006-07-19 |
| 1174553630 | Gedge David Rosson | Surgery | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2006-07-03 |
| Find all providers in BALTIMORE | ||||
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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.