Provider Demographics
NPI:1467987446
Name:BRODINE, JOSEPH BLISS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:BLISS
Last Name:BRODINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9101 FRANKLIN SQUARE DR STE 300
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3966
Mailing Address - Country:US
Mailing Address - Phone:443-777-2000
Mailing Address - Fax:443-777-2034
Practice Address - Street 1:9101 FRANKLIN SQUARE DR STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-3966
Practice Address - Country:US
Practice Address - Phone:443-777-2000
Practice Address - Fax:443-777-2034
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2021-08-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD91600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine