Derrick Maurice Broadaway in Hampton - General Practice
Derrick Maurice Broadaway - NPI 1336292952
Derrick Maurice Broadaway is a General Practice in Hampton, Virginia. Derrick Maurice Broadaway practices all healthcare services and medical treatments related to General Practice. The NPI Number for Derrick Maurice Broadaway is 1336292952. The last update date is 2023-11-27.
Derrick Maurice Broadaway's current location address is 3709 Kecoughtan Rd, Hampton, Virginia. You can contact this provider via phone number 7577228507 and fax number 7576908765. The mailing address for Derrick Maurice Broadaway is 3709 Kecoughtan Rd, Hampton, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Derrick Maurice Broadaway |
|---|---|
| Address | 3709 Kecoughtan Rd, Hampton, Virginia |
| Phone Number | 7577228507 |
| Fax Number | 7576908765 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1336292952 |
|---|---|
| Provider Enumeration Date | 2007-01-18 |
| Last Updated Date | 2023-11-27 |
Provider Mailing Address Detail
| Address | 3709 Kecoughtan Rd |
|---|---|
| City | Hampton |
| State | Virginia (VA) |
| Post Code | 236694405 |
| Phone Number | 7577228507 |
| Fax Number | 7576908765 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 401007977 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 106546 | VI | -- |
Post Comment/ Review Below
What is the unique identification code assigned to Derrick Maurice Broadaway by the Centers for Medicare & Medicaid Services?
The Derrick Maurice Broadaway has been issued the NPI (National Provider Identifier) 1336292952. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Derrick Maurice Broadaway is physically located?
The Derrick Maurice Broadaway is physically situated at the following address: 3709 Kecoughtan Rd, Hampton, VA, 236694405.
What is Derrick Maurice Broadaway's specialized field of practice, and what is the corresponding taxonomy classification code?
The Derrick Maurice Broadaway's area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.
When did Derrick Maurice Broadaway receive its 1336292952 assignment?
The Derrick Maurice Broadaway was assigned its 1336292952 on 2007-01-18, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Derrick Maurice Broadaway last refreshed?
The information related to the Derrick Maurice Broadaway, including its address, specialty, and other relevant details, was last updated on 2023-11-27.
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