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General NPI Number Information
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NPI Number | 1578720710
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Entity Type | Organization
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Legal Business Name | JAMES DAVID BRODELL, M.D., INC.
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Dates
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Enumeration Date | 05/16/2008
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Last Update Date | 03/16/2010
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Provider Practice Location Address
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Address Line | 2614 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44483-6204
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Country | US
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Telephone | 330-394-8181
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Fax | 330-393-4849
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Provider Business Mailing Address
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Address Line | 2614 E MARKET ST
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City | WARREN
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State | OH
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Zip | 44483-6204
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Country | US
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Telephone | 330-394-8181
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Fax | 330-393-4849
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES DAVID BRODELL SR.
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Credential | M.D.
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Telephone | 330-394-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 35-04-8150B
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License Number State | OH
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