IndividualActive
John Broderick, M.D.
NPI 1508939976 · Clinical Neurophysiology Physician · Mequon, WI
Provider details
- NPI number
- 1508939976
- Entity type
- Individual
- Primary specialty
- Clinical Neurophysiology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 46762-020 (WI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
13133 N Port Washington Rd
Suite G06
Mequon, WI 53097-2419
Phone: (262) 243-8371
Fax: (262) 243-8342
Approximate (ZIP-level) locationGet directions
Mailing address
4425 N Port Washington Rd
Glendale, WI 53212-1082
Registry dates
- Enumerated
- 2006-11-15
- Last updated
- 2012-06-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.