Provider Demographics
NPI:1679736797
Name:BROHEZ, MURIELLE (MD)
Entity Type:Individual
Prefix:
First Name:MURIELLE
Middle Name:
Last Name:BROHEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 STONE TRACE DR
Mailing Address - Street 2:
Mailing Address - City:MT STERLING
Mailing Address - State:KY
Mailing Address - Zip Code:40353-9386
Mailing Address - Country:US
Mailing Address - Phone:859-737-9900
Mailing Address - Fax:859-737-0050
Practice Address - Street 1:225 HOSPITAL DR STE 315
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:KY
Practice Address - Zip Code:40391-7628
Practice Address - Country:US
Practice Address - Phone:859-737-9900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2018-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35099229208600000X
IN01080900A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0065498Medicaid
OHH096210Medicare PIN