PATRICK THOMAS BRODERICK (NPI# 1760691083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760691083 |
| Entity Type | Individual |
| Full Name | PATRICK THOMAS BRODERICK |
| Credential | MD |
| Practice Address |
4700 Waters Ave 2nd Floor, Georgia Ear Savannah GA 31404-6220 |
| Practice Telephone | 9129885050 |
| Mailing Telephone | 9129885050 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2011-07-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 27983AL | AL | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 2008018932 | MO | Allopathic & Osteopathic Physicians |
| Y | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
065999 | GA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801139571 | Patrick J Broderick | Anesthesiology | Danbury Hospital, 24 Hospital Avenue, Danbury, CT 06810 | 2013-04-01 |
| 1255345708 | Patrick Broderick | Emergency Medicine | 24 Hospital Ave, Danbury, CT 06810-6099 | 2006-07-28 |
| 1598710071 | Patrick Broderick | Pathology | 30 Shelburne Rd, Stamford, CT 06902-3628 | 2006-05-23 |
| Street Address |
4700 WATERS AVE 2ND FLOOR, GEORGIA EAR |
| City | SAVANNAH |
| State | GA |
| Zip Code | 31404-6220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023012010 | Peter M Britt | Radiology | 4700 Waters Ave, Savannah, GA 31404-6220 | 2005-06-08 |
| 1255938288 | Mckenna Maria Valencia | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-10-02 |
| 1184239451 | Avery Thomas Helms | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-09-13 |
| 1619580800 | Matthew Shannon | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-08-26 |
| 1679184840 | Anna Tincher | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-08-12 |
| 1669083168 | Christie Vernon Klinginsmith | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-08-10 |
| 1396355004 | Noah Radjenovic | Anesthesiologist Assistant | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-08-06 |
| 1558987115 | Alyssa Nadji | Registered Nurse | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-06-19 |
| 1952926065 | Mary Helen Ondriezek | Registered Nurse | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-06-15 |
| 1326661463 | Danielle Marie Carroll | Pharmacist | 4700 Waters Ave, Savannah, GA 31404-6220 | 2020-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043864580 | Carli A Boatright | Registered Nurse | 4750 Waters Ave Suite 206, Savannah, GA 31404 | 2019-08-01 |
| 1619530573 | Morgan Johnson | Student in an Organized Health Care Education/Training Program | Memorial Health University Medical Center, 4700 Waters Ave, Savannah, GA 31404 | 2019-04-17 |
| 1477050243 | Kevin Timperman | Student in an Organized Health Care Education/Training Program | 4700 Waters Avenus, Surgery Residency Program, Mhumc, Savannah, GA 31404 | 2018-04-09 |
| 1376048959 | Nina Jo Paletta | Student in an Organized Health Care Education/Training Program | Memorial University Medical Center, 4700 Waters Ave., Savannah, GA 31404 | 2018-03-27 |
| 1972036200 | Jose Adrian Lara Gonzalez | Student in an Organized Health Care Education/Training Program | 4700 Waters Ave, Memorial University Medical Center, Internal Medicine Residency Program, Savannah, GA 31404 | 2017-04-04 |
| 1407210396 | Lexie Hester Vaughn | Student in an Organized Health Care Education/Training Program | 1250 East 66th St, Savannah, GA 31404 | 2016-04-07 |
| 1336503291 | Miles Love | Student in an Organized Health Care Education/Training Program | 1250 East 66th Street, Savannah, GA 31404 | 2016-04-07 |
| 1134536881 | David Patch | Specialist/Technologist | Pediatric Residency Program, Memorial University, Medical Center 4700 Waters Avenue, Savannah, GA 31404 | 2014-07-15 |
| 1962846683 | Alan Danilo Zevallos | Internal Medicine | 4700 Waters Avenue, University Medical Center, Internal Medicine Residency Program, Memorial Health, Savannah, GA 31404 | 2013-04-24 |
| 1730446394 | Joshua Ryan Fann | Prosthetist | 3840 Waters Ave, Savannah, GA 31404 | 2012-04-19 |
| Find all providers in zip 31404 | ||||
| Taxonomy Code | 2080P0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Cardiology |
| A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356450910 | Savannah Children's Heart Center, PC | Pediatrics | 4750 Waters Ave, Suite 512, Savannah, GA 31404-6200 | 2006-08-29 |
| 1891804456 | Kenneth D Burch | Pediatrics | 4750 Waters Ave, Suite 512, Savannah, GA 31404-6200 | 2006-08-29 |
| 1578679197 | Joseph Blake Long | Pediatrics | 4750 Waters Ave, Suite 512, Savannah, GA 31404-6200 | 2006-08-23 |
| 1912012741 | John S Pastorek | Pediatrics | 4750 Waters Ave, Suite 512, Savannah, GA 31404-6200 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679013452 | Baptist Specialty Physicians Inc | Pediatrics | 3301 N Oak St Ext, Valdosta, GA 31605 | 2017-02-28 |
| 1720408800 | Andrew Porter | Pediatrics | 202 Village Center Pkwy, Stockbridge, GA 30281-9044 | 2014-04-16 |
| 1689606782 | Albert Tuboku-metzger | Pediatrics | 202 Village Center Parkway, Stockbridge, GA 30281 | 2006-07-07 |
| 1992746929 | Deepti Singh | Pediatrics | 2069 Teron Trce, Suite 300, Dacula, GA 30019-1665 | 2006-06-09 |
| 1770521197 | Margaret J Strieper | Pediatrics | 1700 Tree Lane, Ste 330, Snellville, GA 30078 | 2006-06-04 |
| 1679523435 | Michael E Mcconnell | Pediatrics | 202 Village Ctr Parkway, Stockbridge, GA 30281 | 2006-05-11 |
| 1366491953 | Derek A Fyfe | Pediatrics | 1405 Clifton Rd, Atlanta, GA 30322 | 2006-05-09 |
| 1528017258 | William T Mahle | Pediatrics | 355 Tower Rd Ne Ste 204, Marietta, GA 30060-9413 | 2006-05-09 |
| 1548232036 | Lazaros K Kochilas | Pediatrics | 2835 Brandywine Road, Suite 300, Atlanta, GA 30341-5540 | 2006-02-07 |
| 1861485914 | Georgia Pediatric Cardiology | Pediatrics | 1045 Southcrest Dr, Ste 220, Stockbridge, GA 30281-6113 | 2005-08-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PATRICK THOMAS BRODERICK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.