Active NPI
Sherman Douglas Broge, RPH
- Pharmacist
- Belleville, MI
National Provider Identifier
1659407765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302023044
- Practice address
- 51341 W Huron River Dr
Belleville, MI 48111-2571 - Phone
- (734) 484-0482
- Fax
- (734) 484-4086
- NPI assigned
- Feb 25, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302023044 | MI | Primary |
Addresses
Primary practice location
51341 W Huron River Dr
Belleville, MI 48111-2571
Mailing address
459 Waterbury CT
Belleville, MI 48111-4928
Phone (734) 697-5019
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302023044 | MI | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659407765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "459 WATERBURY CT",
"city": "BELLEVILLE",
"state": "MI",
"postal_code": "481114928",
"telephone_number": "734-697-5019"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51341 W HURON RIVER DR",
"city": "BELLEVILLE",
"state": "MI",
"postal_code": "481112571",
"telephone_number": "734-484-0482",
"fax_number": "734-484-4086"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROGE",
"first_name": "SHERMAN",
"middle_name": "DOUGLAS",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302023044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belleville, MI
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.