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General NPI Number Information
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NPI Number | 1164412078
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Entity Type | Individual
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Provider Name | BURTON S BRODSKY MD
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Gender | Male
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Dates
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Enumeration Date | 10/24/2005
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 5308 HARROUN RD STE 175
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City | SYLVANIA
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State | OH
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Zip | 43560-2190
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Country | US
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Telephone | 419-824-5608
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Fax | 419-882-3686
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Provider Business Mailing Address
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Address Line | 18000 W 9 MILE RD STE 200
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City | SOUTHFIELD
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State | MI
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Zip | 48075-4020
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Country | US
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Telephone | 248-336-4000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301064721
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 35.126642
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License Number State | OH
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