Brodrick, Peter Samuel
Brodrick, Peter Samuel is an individual health care provider with primary practice located at 360 Sherman St Suite 100, Saint Paul MN 55102-2564. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Brodrick, Peter Samuel can be contacted via phone (651) 241-5080.Contact Information
Primary practice address
360 Sherman St Suite 100
Saint Paul MN 55102-2564
Phone: (651) 241-5080
Fax: (651) 241-5958
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 45519 | Minnesota |
Profile Details
| NPI number | 1720041528 |
|---|---|
| LBN Legal business name | Brodrick, Peter Samuel |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 11th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720041528 | NPPES |
| Minnesota | MEDICAID | 34122300 |
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