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General NPI Number Information
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NPI Number | 1619086444
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Entity Type | Individual
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Provider Name | EDWARD BROMBERG MD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1413A THOMPSON CIR
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City | GARDENDALE
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State | AL
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Zip | 35071-2514
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Country | US
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Telephone | 205-631-8887
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Fax | 205-631-9126
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Provider Business Mailing Address
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Address Line | 1413A THOMPSON CIR
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City | GARDENDALE
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State | AL
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Zip | 35071-2514
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Country | US
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Telephone | 205-631-8887
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Fax | 205-631-9126
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 6794
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License Number State | AL
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