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NPI Code Detail

MEDICARE: DR. MARITA N BROOME M.D.

MEDICARE: DR. MARITA N BROOME M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianMD19889DC
2207P00000XEmergency Medicine PhysicianD50332MD

General Provider Information

NPI Number : 1194793455
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARITA N BROOME M.D.
Provider Business Mailing Address
First Line : 2101 E JEFFERSON ST
Second Line : KAISER PERMANENTE MEDICARE ENROLLMENT
City : ROCKVILLE
State : MD
Zip : 20852-4908
Country : US
Telephone Number : 301-816-2424
Fax Number :
Provider Business Practice Location Address
First Line : 655 WATKINS MILL RD
Second Line : KAISER PERMANENTE GAITHERSBURG MEDICAL CENTER
City : GAITHERSBURG
State : MD
Zip : 20879-3301
Country : US
Telephone Number : 240-632-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/10/2006
Last Update Date : 06/26/2021

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