Basic Information
| Provider Information | |||||||||
| NPI: | 1457474363 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BROSNAHAN | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | DANIEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D., M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 978 HUNTING HORN WAY W | ||||||||
| Address2: | |||||||||
| City: | EVANS | ||||||||
| State: | GA | ||||||||
| PostalCode: | 308094828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7063643888 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1120 15TH ST | ||||||||
| Address2: | |||||||||
| City: | AUGUSTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 309120004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7067210211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | RTP001199 | GA | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 059132 | GA | N | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.