Provider Demographics
NPI:1649214552
Name:BROOKER, DAVID R (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:R
Last Name:BROOKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:6945 US 322 UNIT 508
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY
Mailing Address - State:PA
Mailing Address - Zip Code:16319-3126
Mailing Address - Country:US
Mailing Address - Phone:814-678-1177
Mailing Address - Fax:814-678-3377
Practice Address - Street 1:6945 US 322 UNIT 508
Practice Address - Street 2:
Practice Address - City:CRANBERRY
Practice Address - State:PA
Practice Address - Zip Code:16319-3126
Practice Address - Country:US
Practice Address - Phone:814-678-1177
Practice Address - Fax:814-678-3377
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044955L207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAF39975Medicare UPIN
PA000309Medicare ID - Type Unspecified