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Contact Information

JOHN S BRODERICK, MD
13133 N PORT WASHINGTON RD
SUITE G06
MEQUON, WI53097-2419
 Phone: 262-243-8371
 Fax: 262-243-8342
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for JOHN S BRODERICK · (Male)

NPI Number 1508939976
Status Active
Credentials MD
Entity Individual
Enumeration date 11/15/2006
Last updated 06/08/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • WI License # 46762-020
Hospital affiliation(s)
  • COLUMBIA ST MARY'S HOSPITAL MILWAUKEE - (Acute Care)
    2323 N LAKE DR
    MILWAUKEE, WI 53211
  • COLUMBIA ST MARY'S HOSPITAL OZAUKEE INC - (Acute Care)
    13111 N PORT WASHINGTON RD
    MEQUON, WI 53097
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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