Broderson, Stephanie O.

Broderson, Stephanie O. is an individual health care provider with primary practice located at 4405 E 26Th St , Sioux Falls SD 57103-4187. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Broderson, Stephanie O. can be contacted via phone (605) 328-9000.

Contact Information

Primary practice address
4405 E 26Th St Sioux Falls SD 57103-4187
Fax: (605) 328-9001
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4547 South Dakota

Profile Details

NPI number 1437154606
LBN Legal business name Broderson, Stephanie O.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2005
Last updated Mar 31st, 2022 - about 2 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 1437154606 NPPES
South Dakota MEDICAID 5610682

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