Broaddus, Samuel B
Broaddus, Samuel B is an individual health care provider with primary practice located at 81 Medical Center Dr Suite 2350, Brunswick ME 04011-2764. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Broaddus, Samuel B can be contacted via phone (207) 373-6690.Contact Information
Primary practice address
81 Medical Center Dr Suite 2350
Brunswick ME 04011-2764
Phone: (207) 373-6690
Fax: (207) 373-6695
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD11648 | Maine |
Profile Details
| NPI number | 1326094335 |
|---|---|
| LBN Legal business name | Broaddus, Samuel B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 25th, 2006 |
| Last updated | Jan 21st, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326094335 | NPPES |
| Maine | MEDICAID | 263730099 | |
| Maine | MEDICAID | 30007671 |
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