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BROMBERG, BURT I       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: MERCY CLINIC CHILDRENS HEART CENTER
621 SOUTH NEW BALLAS ROAD #198A
ST. LOUIS MO 63141

Address last updated on 10/2/2019
Phone #: (314) 251-6777
Fax #:
County: NOT OKLAHOMA
License: 29163
Dated: 7/3/2012
Expires: 1/30/2021
License Type: Medical Doctor
Specialty: Pediatric Cardiology
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: UNIV OF SOUTH AL COLL OF MED, MOBILE AL 36688
Graduated: 6 / 1981
CME Year: 2021
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF PEDIATRICS - Pediatric Cardiology
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: Mercy Hospital Ada (frmly Valley View Regional Hospital)
Ada, OK
Mercy Hospital OKC
Oklahoma City, OK
Mercy Memorial Health Center, Inc. - Ardmore
Ardmore, OK
Locations: Hours: Languages:
MERCY CLINIC CHILDRENS HEART CENTER
621 SOUTH NEW BALLAS ROAD #198A
ST. LOUIS MO 63141

Phone #: (314) 251-6777
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
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