Provider Demographics
NPI:1457614760
Name:BROZ, ANN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:BROZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14950 STATE ROAD 23
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-7564
Mailing Address - Country:US
Mailing Address - Phone:574-243-2221
Mailing Address - Fax:574-204-9650
Practice Address - Street 1:14950 STATE ROAD 23
Practice Address - Street 2:
Practice Address - City:GRANGER
Practice Address - State:IN
Practice Address - Zip Code:46530-7564
Practice Address - Country:US
Practice Address - Phone:574-243-2221
Practice Address - Fax:574-204-9650
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01077299A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology