Provider Demographics
NPI:1144284928
Name:BROUHARD, BEN H (MD)
Entity type:Individual
Prefix:DR
First Name:BEN
Middle Name:H
Last Name:BROUHARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2500 METROHEALTH DR
Mailing Address - Street 2:ROOM A-109
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1900
Mailing Address - Country:US
Mailing Address - Phone:216-778-4900
Mailing Address - Fax:216-778-2338
Practice Address - Street 1:2500 METROHEALTH DR
Practice Address - Street 2:ROOM A-109
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1900
Practice Address - Country:US
Practice Address - Phone:216-778-4900
Practice Address - Fax:216-778-2338
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH350577202080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0723220Medicaid
OHBR7274241Medicare ID - Type Unspecified
OH0723220Medicaid