David Bromberg, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

D0017851 Issued in MD

Practice address

1475 Taney Ave
Ste 201
Frederick, MD 21702-5126

Phone

(301) 662-0133

Fax

(301) 695-8604

NPI assigned

Jun 10, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Trusted Doctors LLC

  • Pediatrics Physician
  • Mount Airy, MD
  • NPI 1013773308
  NPD (past)
• Trusted Doctors LLC

  • Pediatrics Physician
  • Frederick, MD
  • NPI 1194581488
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276646400000",
    "number": "1205830833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 TANEY AVE",
            "address_2": "STE 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217025126",
            "telephone_number": "301-662-0133",
            "fax_number": "301-695-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 TANEY AVE",
            "address_2": "STE 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217025126",
            "telephone_number": "301-662-0133",
            "fax_number": "301-695-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROMBERG",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2010-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MD",
            "license": "D0017851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312321900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brighter Living Mental Health Services
• Brilliant Birthing and Lactation, LLC
• Susan Barnett Brinkley, M.D.
• Kwadwo O Britwum
• Michelle L Britwum, BCBA, LBA
• Gayle Bromberg, LCSW-C
• Jason Gabriel Bromer, M.D.
• Brook Lane Behavioral Services, Inc.
• Brook Lane Behavioral Services, Inc.
• Brook Lane Behavioral Services, Inc.

• Pediatric Adolescent Medicine Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Pediatric Adolescent Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.