Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 4301071748 | MI |
Y | 2080P0210X | Pediatric Nephrologist | 37492 | IA |
N | 2080P0210X | Pediatric Nephrologist | 4301071748 | MI |
NPI | 1679587851 |
---|---|
Provider Name | Patrick D Brophy |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 11/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4264455 | (05) | MI |
71164 | WELLMARK BCBS (01) | IA |
H28126 | (02) |