Dr. Daniel J Broderick, DO
Hospitalist in Boise, ID. Individual provider (NPI-1).
NPI number1487141990
StatusActive
Last updated in NPPESOct 13, 2022
Details
- NPI
- 1487141990
- Entity type
- Individual (NPI-1)
- Name
- Dr. Daniel J Broderick
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2018
- Certification date
- Oct 13, 2022
- Last updated
- Oct 13, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208M00000X | Hospitalist | O-1724 | ID | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
1055 N Curtis RdBoise, ID 83706-1309
Phone 208-367-7350
Mailing address
3340 E Goldstone DrMeridian, ID 83642-1026
Phone 208-367-5170 · Fax 208-367-5180
Other practice locations
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Greenville, NC 27834-2818
Phone 252-744-0766 · Fax 252-744-0392
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