Provider Demographics
NPI:1942415344
Name:BROERING, JULIE R (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:R
Last Name:BROERING
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1 PRESTIGE PL
Mailing Address - Street 2:STE 550
Mailing Address - City:MIAMISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:45342-6115
Mailing Address - Country:US
Mailing Address - Phone:937-762-1306
Mailing Address - Fax:937-522-7626
Practice Address - Street 1:2449 ROSS MILLVILLE RD
Practice Address - Street 2:STE. B50
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013-8951
Practice Address - Country:US
Practice Address - Phone:513-737-6068
Practice Address - Fax:513-737-6681
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2020-11-23
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Provider Licenses
StateLicense IDTaxonomies
OH35085170207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2769188Medicaid
OHH387840Medicare PIN