MEDICARE: DR. BRIAN EMANUEL BROCATO D.O.

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
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207VM0101X	Maternal & Fetal Medicine Physician	DO.1415	AL

General Provider Information

NPI Number	:	1538385703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN EMANUEL BROCATO D.O.

Provider Business Mailing Address
First Line	:	2006 BROOKWOOD MEDICAL CTR DR STE 604
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6845
Country	:	US
Telephone Number	:	205-877-5113
Fax Number	:	205-877-5130

Provider Business Practice Location Address
First Line	:	2006 BROOKWOOD MEDICAL CTR DR STE 604
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-6845
Country	:	US
Telephone Number	:	205-877-5113
Fax Number	:	205-877-5130

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	08/22/2018

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