Broviac, John W.

Broviac, John W. is an individual health care provider with primary practice located at 2601 Coolidge Rd Ste B, East Lansing MI 48823-6361. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Broviac, John W. can be contacted via phone (517) 913-4050.

Contact Information

Primary practice address
2601 Coolidge Rd Ste B East Lansing MI 48823-6361
Phone: (517) 913-4050
Fax: (517) 333-0893
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 4301034184 Michigan

Profile Details

NPI number 1124070479
LBN Legal business name Broviac, John W.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 16th, 2006
Last updated Jan 13th, 2010 - about 15 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 1124070479 NPPES
Michigan Other 0M54760003 MEDICARE PLUS BLUE
Michigan Other 1001247 MEDICARE PLUS BLUE
Michigan Other 1001247 MEDICARE PLUS BLUE
Michigan MEDICAID 3421169 MEDICARE PLUS BLUE
Michigan Other 5151077 MEDICARE PLUS BLUE
Michigan Other 1001247 MEDICARE PLUS BLUE
Michigan Other 1103351181 MEDICARE PLUS BLUE
Michigan Other 200000001388 MEDICARE PLUS BLUE
Michigan Other 200000001388 MEDICARE PLUS BLUE
Michigan Other 110159644 MEDICARE PLUS BLUE
Michigan Other 194055 MEDICARE PLUS BLUE
Michigan MEDICAID 3421187 MEDICARE PLUS BLUE

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