Amy L Braddock is a Surgery in Pontiac, Michigan. Amy L Braddock practices all healthcare services and medical treatments related to Surgery. The NPI Number for Amy L Braddock is 1578632246. The last update date is 2007-07-08.
Amy L Braddock's current location address is 44555 Woodward Ave, Pontiac, Michigan. You can contact this provider via phone number 2483387171 and fax number 2488583830. The mailing address for Amy L Braddock is 44555 Woodward Ave, Pontiac, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Amy L Braddock |
|---|---|
| Address | 44555 Woodward Ave, Pontiac, Michigan |
| Phone Number | 2483387171 |
| Fax Number | 2488583830 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1578632246 |
|---|---|
| Provider Enumeration Date | 2006-11-07 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 44555 Woodward Ave |
|---|---|
| City | Pontiac |
| State | Michigan (MI) |
| Post Code | 48341 |
| Phone Number | 2483387171 |
| Fax Number | 2488583830 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 4301074104 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 206348782 | BCBSM | ||
| 4736387 | MI | -- | |
| AB074104 | STATE LICENSE |
Post Comment/ Review Below
What is the unique identifier code issued to Amy L Braddock by the Centers for Medicare & Medicaid Services (CMS)?
The Amy L Braddock has been assigned the NPI (National Provider Identifier) 1578632246. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete physical address where Amy L Braddock is located?
The Amy L Braddock is situated at the following address: 44555 Woodward Ave, Pontiac, MI, 48341.
What is the Amy L Braddock's area of specialization and corresponding taxonomy classification?
The Amy L Braddock's specialty field is Surgery, and it falls under the taxonomy code 208600000X, which categorizes healthcare providers based on their specialties.
On what date did the Amy L Braddock receive its 1578632246 assignment from the Centers for Medicare & Medicaid Services?
The Amy L Braddock was assigned its 1578632246 by the Centers for Medicare & Medicaid Services on 2006-11-07.
When was the information regarding Amy L Braddock most recently updated?
The details pertaining to the Amy L Braddock, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.