Active NPI
Samuel Broder, M.D.
- Independent Medical Examiner Physician
- Bethesda, MD
National Provider Identifier
1306049572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Medical Examiner Physician
- License
- D0017618
- Practice address
- 8612 Honeybee LN
Bethesda, MD 20817-6941 - Phone
- (240) 453-3300
- Fax
- (240) 453-3074
- NPI assigned
- Jun 6, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Independent Medical Examiner Physician | 202C00000X | D0017618 | MD | Primary |
Addresses
Primary practice location
8612 Honeybee LN
Bethesda, MD 20817-6941
Mailing address
8612 Honeybee LN
Bethesda, MD 20817-6941
Phone (240) 453-3300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0017618 | MD | MD | Independent Medical Examiner Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306049572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8612 HONEYBEE LN",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208176941",
"telephone_number": "240-453-3300",
"fax_number": "240-453-3074"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8612 HONEYBEE LN",
"city": "BETHESDA",
"state": "MD",
"postal_code": "208176941",
"telephone_number": "240-453-3300",
"fax_number": "240-453-3074"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRODER",
"first_name": "SAMUEL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "202C00000X",
"taxonomy_group": "",
"desc": "Independent Medical Examiner",
"state": "MD",
"license": "D0017618",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.