Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 58.002211 | OH |
NPI | 1003023771 |
---|---|
Provider Name | Dr. Matthew Craig Bromley |
First Address | Newark, OH 43055-1822 |
Second Address | Newark, OH 43055-1822 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 13/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2997128 | (05) | OH |