Dawn Broderick, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0045956 Issued in MD

Practice address

18111 Prince Philip Dr
Suite 201
Olney, MD 20832-1513

Phone

(301) 774-7714

Fax

(301) 686-7164

NPI assigned

May 27, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Previously, effective Aug 23, 2012 through Aug 23, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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)

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430092800000",
    "number": "1801899489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "SUITE 201",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321513",
            "telephone_number": "301-774-7714",
            "fax_number": "301-686-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18111 PRINCE PHILIP DR",
            "address_2": "SUITE 201",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321513",
            "telephone_number": "301-774-7714",
            "fax_number": "301-686-7164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODERICK",
        "first_name": "DAWN",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-27",
        "last_updated": "2015-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0045956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher M Brandt, ATC, PTA
• Ryann Brickley
• Brighter Days Child and Family Therapy
• Catherine Brinlee
• Mercedes Brito, PTA
• Rachel S Brody, LCSW-C
• Carol Anne Brohawn, LCMFT
• Brad Bromwell, SA-C
• Irina V Brown, MD
• Kendall Alexandra Brown, MD

• Internal Medicine Physician in Olney, MD
• Providers in Olney, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.