Provider Demographics
NPI:1508946039
Name:BROPHY, CATHERINE I (MD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:I
Last Name:BROPHY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2025 CHANEYVILLE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OWINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20736-4300
Mailing Address - Country:US
Mailing Address - Phone:410-286-3865
Mailing Address - Fax:410-286-8085
Practice Address - Street 1:2025 CHANEYVILLE RD STE 200
Practice Address - Street 2:
Practice Address - City:OWINGS
Practice Address - State:MD
Practice Address - Zip Code:20736-4300
Practice Address - Country:US
Practice Address - Phone:410-286-3865
Practice Address - Fax:410-286-8085
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD45235207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD364361100Medicaid
G08417Medicare UPIN
MD489L453CMedicare ID - Type Unspecified