Stephen R Broadwater in Augusta - Specialist
Stephen R Broadwater - NPI 1083697478
Stephen R Broadwater is a Specialist in Augusta, Georgia. Stephen R Broadwater practices all healthcare services and medical treatments related to Specialist. The NPI Number for Stephen R Broadwater is 1083697478. The last update date is 2015-10-19.
Stephen R Broadwater's current location address is 3614 J Dewey Gray Circle, Augusta, Georgia. You can contact this provider via phone number 7069229222 and fax number 7069225766. The mailing address for Stephen R Broadwater is 3614 J Dewey Gray Circle, Augusta, Georgia. To know further, please read the information below!
Provider Profile Detail
Provider Name | Stephen R Broadwater |
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Address | 3614 J Dewey Gray Circle, Augusta, Georgia |
Phone Number | 7069229222 |
Fax Number | 7069225766 |
Sole Proprietor | N |
Credentials | M.D. |
NPI Number Detail
NPI Number | 1083697478 |
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Provider Enumeration Date | 2005-11-21 |
Last Updated Date | 2015-10-19 |
Provider Mailing Address Detail
Address | 3614 J Dewey Gray Circle |
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City | Augusta |
State | Georgia (GA) |
Post Code | 30909 |
Phone Number | 7069229222 |
Fax Number | 7069225766 |
Provider's Primary Taxonomy Detail
Speciality | Specialist |
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Taxonomy | 174400000X |
Licence No | 50003 |
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
000905154A | GA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Stephen R Broadwater by the Centers for Medicare & Medicaid Services?
The Stephen R Broadwater has been assigned the NPI (National Provider Identifier) 1083697478 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Stephen R Broadwater's physical address?
The Stephen R Broadwater is physically located at 3614 J Dewey Gray Circle, in the city of Augusta, GA, with the postal code 30909.
What is Stephen R Broadwater's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Stephen R Broadwater is Specialist, and the taxonomy code that categorizes this field of expertise is 174400000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1083697478 to Stephen R Broadwater?
The Centers for Medicare & Medicaid Services originally issued the 1083697478 to Stephen R Broadwater on 2005-11-21.
As of what date was the information pertaining to Stephen R Broadwater, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Stephen R Broadwater, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2015-10-19.