Broderick, Paul Eugene

Broderick, Paul Eugene is an sole proprietor health care provider with primary practice located at 1215 Hadley Rd Ste 206 , Mooresville IN 46158-2905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Broderick, Paul Eugene can be contacted via phone (317) 834-1919.

Contact Information

Primary practice address
1215 Hadley Rd Ste 206 Mooresville IN 46158-2905
Fax: (317) 834-1920
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 02001623A Indiana

Profile Details

NPI number 1467459958
LBN Legal business name Broderick, Paul Eugene
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 30th, 2005
Last updated Apr 14th, 2023 - about last year

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 1467459958 NPPES
Indiana Other 000000095924 ANTHEM
Indiana Other MEDICARE ANTHEM
Indiana MEDICAID 200037350 ANTHEM

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