Broughton, Peter Bradley
Broughton, Peter Bradley is an individual health care provider with primary practice located at 77 Nealy Ave 633D Medical Group, Joint Base Langley-Eustis VA 23665-2040. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Aerospace Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Broughton, Peter Bradley can be contacted via phone (937) 607-7205.Contact Information
Primary practice address
77 Nealy Ave 633D Medical Group
Joint Base Langley-Eustis VA 23665-2040
Phone: (937) 607-7205
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Aerospace Medicine | 2083A0100X | 0101272984 | Virginia |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0101272984 | Virginia |
Profile Details
| NPI number | 1720617558 |
|---|---|
| LBN Legal business name | Broughton, Peter Bradley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 3rd, 2020 |
| Last updated | Jun 26th, 2023 - about 3 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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