Brokaw, Jason P

Brokaw, Jason P is an individual health care provider with primary practice located at 2700 Quarry Lake Drive Suite 300, Baltimore MD 21209-3746. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as his primary health care specialty. Brokaw, Jason P can be contacted via phone (410) 377-8900.

Contact Information

Primary practice address
2700 Quarry Lake Drive Suite 300 Baltimore MD 21209-3746
Phone: (410) 377-8900
Fax: (410) 377-3156
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 2081P2900X D61663 Maryland

Profile Details

NPI number 1033107941
LBN Legal business name Brokaw, Jason P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2005
Last updated Jun 6th, 2020 - about 6 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 1033107941 NPPES
Maryland MEDICAID 405740600

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