Doctor Name: | MICHAEL H. BRODER |
NPI Number: | 1104830348 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | DO313 |
Business Practice Address: | 2034 Chestnut St Montgomery, AL - 361061111 |
Business Phone Number: | 3342690212 |
Business Fax Number: | 3342692144 |
Mailing Address: | 2034 Chestnut St, MONTGOMERY |
State: | AL |
Postal Code: | 361061111 |
Phone Number: | 3342690212 |
Fax Number: | 3342692144 |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 03/27/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | DO313 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |