Provider Demographics
NPI:1285653428
Name:BROZMAN, BRANIMIR (MD)
Entity Type:Individual
Prefix:
First Name:BRANIMIR
Middle Name:
Last Name:BROZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:498 ESSEX ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-3990
Mailing Address - Country:US
Mailing Address - Phone:207-947-0558
Mailing Address - Fax:207-947-0344
Practice Address - Street 1:498 ESSEX ST
Practice Address - Street 2:SUITE 105
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3990
Practice Address - Country:US
Practice Address - Phone:207-947-0558
Practice Address - Fax:207-947-0344
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0160982084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME339220099Medicaid
ME7181550OtherAETNA
ME5099650OtherCIGNA
ME060522OtherANTHEM BLUE SHIELD
ME7181550OtherAETNA
MEME0052Medicare PIN