Broadwell, Scott Russell

Broadwell, Scott Russell is an individual health care provider with primary practice located at 700 E Morehead St Ste 300, Charlotte NC 28202-2788. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Broadwell, Scott Russell can be contacted via phone (704) 334-7800.

Contact Information

Primary practice address
700 E Morehead St Ste 300 Charlotte NC 28202-2788
Phone: (704) 334-7800
Fax: (704) 414-7512
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 31804 South Carolina
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 31804 South Carolina
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 2008-01123 North Carolina
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 2008-01123 North Carolina

Profile Details

NPI number 1518948561
LBN Legal business name Broadwell, Scott Russell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 8th, 2005
Last updated Dec 20th, 2017 - about 7 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 1518948561 NPPES
South Carolina MEDICAID N23008
South Carolina Other P00655691
South Carolina MEDICAID 5909660

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