Provider Demographics
NPI:1851828412
Name:BROTZMAN, ERICA (DO)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:BROTZMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7813 SHRADER RD
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23294-4210
Mailing Address - Country:US
Mailing Address - Phone:804-264-4545
Mailing Address - Fax:804-264-4260
Practice Address - Street 1:7813 SHRADER RD
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23294-4210
Practice Address - Country:US
Practice Address - Phone:804-264-4545
Practice Address - Fax:804-264-4260
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0102206707207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program