Broad, Louis T

Broad, Louis T is an individual health care provider with primary practice located at 132 S 10Th St 480 Main Building, Philadelphia PA 19107-5244. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Broad, Louis T can be contacted via phone (215) 955-8900.

Contact Information

Primary practice address
132 S 10Th St 480 Main Building Philadelphia PA 19107-5244
Phone: (215) 955-8900
Fax: (215) 955-5245
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X MD016957E Pennsylvania

Profile Details

NPI number 1710085147
LBN Legal business name Broad, Louis T
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 20th, 2006
Last updated Jun 22nd, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710085147 NPPES
Pennsylvania MEDICAID 0059855001

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