Provider Demographics
NPI:1760448898
Name:BROMLEY, HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:BROMLEY
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 1:5683 S REX RD
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3821
Mailing Address - Country:US
Mailing Address - Phone:901-350-0678
Mailing Address - Fax:901-350-0677
Practice Address - Street 1:5683 S REX RD
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3821
Practice Address - Country:US
Practice Address - Phone:901-350-0678
Practice Address - Fax:901-350-0677
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2022-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38019207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3892011Medicare ID - Type Unspecified
3892011Medicare ID - Type Unspecified
C61177Medicare UPIN