Broaddus, Stephen M

Broaddus, Stephen M is an individual health care provider with primary practice located at 6800 State Route 162 , Maryville IL 62062-8500. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Broaddus, Stephen M can be contacted via phone (618) 267-0401.

Contact Information

Primary practice address
6800 State Route 162 Maryville IL 62062-8500
Phone: (618) 267-0401
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 101441 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 085005004 Illinois

Profile Details

NPI number 1033452107
LBN Legal business name Broaddus, Stephen M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2013
Last updated May 19th, 2021 - about 3 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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