Provider Demographics
NPI:1083652408
Name:BROZA, DAVID J (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:J
Last Name:BROZA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:70 KENYON AVE
Mailing Address - Street 2:SUITE 321
Mailing Address - City:WAKEFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02879-4239
Mailing Address - Country:US
Mailing Address - Phone:401-789-5770
Mailing Address - Fax:401-782-8530
Practice Address - Street 1:3461 S COUNTY TRL
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1465
Practice Address - Country:US
Practice Address - Phone:401-471-6440
Practice Address - Fax:401-889-5082
Is Sole Proprietor?:No
Enumeration Date:2006-06-04
Last Update Date:2023-12-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
RIMD08967207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI050445136OtherTAX ID
RI7005010Medicaid
RI050452097OtherTAX ID NUMBER
RIG17750Medicare UPIN
RI7005010Medicaid