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General NPI Number Information
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NPI Number | 1538749593
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Entity Type | Individual
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Provider Name | ALEXIS ROMPRE-BRODEUR MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 10 CENTER DRIVE ROOM 1-5940W
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City | BETHESDA
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State | MD
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Zip | 20892-0001
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Country | US
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Telephone | 240-328-8003
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Fax |
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Provider Business Mailing Address
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Address Line | 5405 TUCKERMAN LN APT 818
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City | ROCKVILLE
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State | MD
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Zip | 20852-7333
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Country | US
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Telephone | 202-329-3158
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | D0090204
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License Number State | MD
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