Stephen R Broadwater M.D.

NPI 1083697478 - Specialist - 174400000X

NPI Details
NPI 1083697478
Gender Male
Enumeration Date 11/21/2005
Last Updated 10/19/2015
Entity Type Individual
Active Over 11 years ago
Practice Location
3614 J DEWEY GRAY CIRCLE
ST A
AUGUSTA GA, 30909, US
Phone (706) 922-9222
Fax (706) 922-5766
Business Location
818 SAINT SEBASTIAN WAY
STE 311
AUGUSTA GA, 30901-2651, US
Phone (706) 724-3473
Fax (706) 724-3493
Toxanomy
Taxonomy Code 174400000X
License State Georgia
License Number 050003
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According to our database, Dr. Stephen R Broadwater M.D. NPI is 1083697478, taxonomy code is 174400000X and license number is 050003, license state is located at Georgia. Stephen R Broadwater M.D. physically located at 3614 J Dewey Gray Circle, Augusta GA, 30909. NPI Number Stephen R Broadwater M.D. has the Individual type.

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1083697478 NPI number is provided on an as is basis without warranty of any kind. 1083697478 is maintained by the National Plan & Provider Enumeration System. The contents of Stephen R Broadwater M.D. are for informational purposes only.