Ian Matthew Broussard D.O.

  • NPI 1871024968
According to our database, the NPI number for Ian Matthew Broussard D.O. is 1871024968 and activated since 7 years ago. Ian Matthew Broussard D.O. is an individual provider who specializes in Student in an Organized Health Care Education/Training Program, and the primary practice location is 809 82nd Pkwy, Myrtle Beach, SC 29572. You can also contact Ian Matthew Broussard D.O. via telephone number is (843) 692-1752. Provider NPI information was last updated on 06/12/2017.

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Overview of Ian Matthew Broussard D.O.

  • NPI number: 1598434045
  • Provider type: Individual
  • Gender: Male
  • Active since: 03/21/2017
  • Last updated: 06/12/2017

Primary Scrop of Practice

  • Taxonomy Code: 390200000X
  • Specialty: Student in an Organized Health Care Education/Training Program
  • License Number: unknow
  • License State: SC

Provider Mailing Address

  • Address: 809 82nd Pkwy
    Grand Strand Medical Center Gme Office
    Myrtle Beach, SC 29572
  • Phone: 843-692-1752
  • Fax: 843-692-1904

Provider Practice Location

  • Address: 809 82nd Pkwy
    Grand Strand Medical Center Gme Office
    Myrtle Beach, SC 29572
  • Phone: 843-692-1752
  • Fax: 843-692-1904

Scope of Practice

  • Taxonomy Code: 207P00000X
  • Specialty: Emergency Medicine
  • License Number: LL41064
  • License State: SC
  • Switch: Yes

Question & Answers

  • Q: What is the npi number?
  • A: An NPI is a 10-digit numeric identifier. It does not carry information about you, such as the State where you practice, your provider type, or your specialization. Your NPI will not change, even if your name, address, taxonomy, or other information changes.
  • Q: What are health care provider taxonomy codes?
  • A: The Health Care Provider (HCP) Taxonomy Codes Codes define a health care service provider type, classification, and area of specialization.
  • Q: What is the npi number for Ian Matthew Broussard D.O.?
  • A: The npi number for Ian Matthew Broussard D.O. is 1871024968.
  • Q: What are Ian Matthew Broussard D.O.'s specialties?
  • A: Ian Matthew Broussard D.O.'s specialties are Student in an Organized Health Care Education/Training Program and different specialities.
  • Q: What is the medical license for Ian Matthew Broussard D.O.?
  • A: The medical license number for Ian Matthew Broussard D.O. is unknow and issued in SC in USA.
  • Q: Where is Ian Matthew Broussard D.O. practice location?
  • A: Ian Matthew Broussard D.O. is practicing at 809 82nd Pkwy, Myrtle Beach, SC 29572.
  • Q: How to contact Ian Matthew Broussard D.O.?
  • A: You can contact Ian Matthew Broussard D.O. via 843-692-1752.