Robert Irving Broder, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

0101027292 Issued in VA

Practice address

301B Park Hill Dr
Fredericksburg, VA 22401-3375

Phone

(540) 310-0041

Fax

(703) 379-9575

NPI assigned

Jul 6, 2006

Sex

Male

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1982635157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11673",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223120673",
            "telephone_number": "703-820-2212",
            "fax_number": "703-379-9575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301B PARK HILL DR",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224013375",
            "telephone_number": "540-310-0041",
            "fax_number": "703-379-9575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODER",
        "first_name": "ROBERT",
        "middle_name": "IRVING",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "VA",
            "license": "0101027292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Grace Britton, RBT
• Chrisonia Reneice Broadnax, LCSW
• Jay David Brock, M.D.
• Lee R Brock, MD
• Piper L Brock, DO
• Alfred J Bromm Jr., PHARMD
• Shirley Nadine Bronston, LCSW
• Brooks Management, Inc (Battlefield Chiropractic Center)
• Clarence Linden Brooks II, D.C.
• Faten K Brooks, RPH

• Dermatology Physician in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Dermatology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.