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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033107941 | NPPES |
| Maryland | MEDICAID | 405740600 |
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