MARY B BROECKERT MD
NPI 1326125576
Family Medicine in Grand Rapids, MI

Q: What is Mary Broeckert's NPI number?

The NPI number for Mary Broeckert is 1326125576. It was assigned to this individual provider in the NPPES registry on November 1, 2006.

Q: What is Mary Broeckert's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Mary Broeckert was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 01, 2006

2332 ALPINE AVE NW, GRAND RAPIDS, MI 49544(616) 391-6220 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mary B Broeckert Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY B BROECKERT MD (NPI 1326125576) is an individual family medicine provider in Grand Rapids, Michigan, licensed in Michigan (4301043572) and active in the NPI registry since November 2006.

NPPES Registry Identity

NPI1326125576

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameMARY B BROECKERTCredential: MD

Location Address2332 ALPINE AVE NWGrand Rapids, MI 49544-1955

Mailing Address100 Michigan St Ne, Mc 109 Attn Julie LGrand Rapids, MI 49503-2560

Phone(616) 391-6220

Sole ProprietorNo

Enumeration DateNovember 1, 2006

Last NPPES UpdateJuly 9, 2007

✔ NPI 1326125576 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MI · 4301043572

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2332 ALPINE AVE NW, Grand Rapids, MI 49544

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Other Identifiers 8

Medicare ID-Type UnspecifiedM33350115MI

Medicaid4935291MI

Other1598712390MI · Group Npi

Other4301043572MI · State License

Medicaid4935255MI

Medicaid4935264MI

Medicaid4935273MI

Medicaid4935246MI

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JAMES POCHERT MD

Internal Medicine