Wallace Broadbent in Kalamazoo - General Practice
Wallace Broadbent - NPI 1861443202
Wallace Broadbent is a General Practice in Kalamazoo, Michigan. Wallace Broadbent practices all healthcare services and medical treatments related to General Practice. The NPI Number for Wallace Broadbent is 1861443202. The last update date is 2009-02-10.
Wallace Broadbent's current location address is 1535 Gull Rd, Kalamazoo, Michigan. You can contact this provider via phone number 2692266933 and fax number 2692266949. The mailing address for Wallace Broadbent is 1535 Gull Rd, Kalamazoo, Michigan. To know further, please read the information below!
Provider Profile Detail
Provider Name | Wallace Broadbent |
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Address | 1535 Gull Rd, Kalamazoo, Michigan |
Phone Number | 2692266933 |
Fax Number | 2692266949 |
Sole Proprietor | N |
Credentials | D.O. |
NPI Number Detail
NPI Number | 1861443202 |
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Provider Enumeration Date | 2006-05-12 |
Last Updated Date | 2009-02-10 |
Provider Mailing Address Detail
Address | 1535 Gull Rd |
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City | Kalamazoo |
State | Michigan (MI) |
Post Code | 490481650 |
Phone Number | 2692266933 |
Fax Number | 2692266949 |
Provider's Primary Taxonomy Detail
Speciality | General Practice |
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Taxonomy | 208D00000X |
Licence No | 5101011784 |
Definition: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
3123256-11 | MI | MEDICAID - THREE RIVERS | |
700G560080 | MI | BCBS GROUP-THREE RIVERS HEALTH | |
WB011784 | MI | BLUE CROSS BLUE SHIELD | |
114572856 | MI | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Wallace Broadbent by the Centers for Medicare & Medicaid Services?
The Wallace Broadbent has been issued the NPI (National Provider Identifier) 1861443202 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Can you provide the Wallace Broadbent's physical address?
The Wallace Broadbent is physically located at 1535 Gull Rd, in the city of Kalamazoo, MI, with the postal code 490481650.
What is Wallace Broadbent's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Wallace Broadbent is General Practice, and the taxonomy classification code that categorizes this area of expertise is 208D00000X.
On what date did the Wallace Broadbent receive its 1861443202 assignment from the Centers for Medicare & Medicaid Services?
The Wallace Broadbent was assigned its 1861443202 by the Centers for Medicare & Medicaid Services on 2006-05-12.
When was the Wallace Broadbent's information last updated?
The Wallace Broadbent's information was last updated on 2009-02-10.
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