Brockett, Molly D

Brockett, Molly D is an individual health care provider with primary practice located at 2002 Medical Pkwy Suite 460, Annapolis MD 21401-3046. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Brockett, Molly D can be contacted via phone (410) 266-2725.

Contact Information

Primary practice address
2002 Medical Pkwy Suite 460 Annapolis MD 21401-3046
Phone: (410) 266-2725
Fax: (410) 224-6793
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X C0003022 Maryland

Profile Details

NPI number 1295778983
LBN Legal business name Brockett, Molly D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Nov 4th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295778983 NPPES
Maryland Other 165783ZEZT MEDICARE PTAN

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