Broussard, Michael Louis

Broussard, Michael Louis is an individual health care provider with primary practice located at 2770 3Rd Ave Ste 210 , Lake Charles LA 70601-0404. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hematology & Oncology, which is considered as his primary health care specialty. Broussard, Michael Louis can be contacted via phone (337) 494-6768.

Contact Information

Primary practice address
2770 3Rd Ave Ste 210 Lake Charles LA 70601-0404
Phone: (337) 494-6768
Fax: (337) 494-6792
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology & Oncology 207RH0003X MD025609 Louisiana

Profile Details

NPI number 1699890376
LBN Legal business name Broussard, Michael Louis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 20th, 2007
Last updated May 12th, 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 1699890376 NPPES
Louisiana MEDICAID 1043281

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