Provider Demographics
NPI:1659995256
Name:BROGAN, JOSHUA DANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:DANIEL
Last Name:BROGAN
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 1:355 WEST 16TH STREET
Mailing Address - Street 2:GOODMAN HALL SUITE 4300
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46202-9410
Mailing Address - Country:US
Mailing Address - Phone:317-274-8157
Mailing Address - Fax:
Practice Address - Street 1:355 WEST 16TH STREET
Practice Address - Street 2:GOODMAN HALL, SUITE 4300
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46202
Practice Address - Country:US
Practice Address - Phone:317-274-8157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-31
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program