Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 8120 | NC |
NPI | 1043353121 |
---|---|
Provider Name | Dr. Steven Andrew Brofsky |
First Address | Matthews, NC 28105-3225 |
Second Address | Matthews, NC 28105-3225 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 15/02/2012 |