Provider Demographics
NPI:1245044510
Name:TLC PERINATAL RICHARD BROTH MD PC
Entity type:Organization
Organization Name:TLC PERINATAL RICHARD BROTH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:BROTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-735-0016
Mailing Address - Street 1:10801 LOCKWOOD DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20901-1562
Mailing Address - Country:US
Mailing Address - Phone:301-681-0004
Mailing Address - Fax:
Practice Address - Street 1:12800 MIDDLEBROOK RD STE 410
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-5284
Practice Address - Country:US
Practice Address - Phone:301-684-0004
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty