Broderick-Cantwell, John Joseph

Broderick-Cantwell, John Joseph is an individual health care provider with primary practice located at 7101 Us Highway 90 Ste 103 , Daphne AL 36526-9510. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry. Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry is his primary health care specialty. Broderick-Cantwell, John Joseph can be contacted via phone (251) 517-5800.

Contact Information

Primary practice address
7101 Us Highway 90 Ste 103 Daphne AL 36526-9510
Phone: (251) 517-5800
Fax: (256) 429-9411
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 28950 Alabama
Allopathic & Osteopathic Physicians / Child & Adolescent Psychiatry 2084P0804X 28950 Alabama

Profile Details

NPI number 1760493365
LBN Legal business name Broderick-Cantwell, John Joseph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2006
Last updated Feb 5th, 2024 - 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 1760493365 NPPES
South Carolina Other 28903 MEDICAL LICENSE
South Carolina MEDICAID Q48343 MEDICAL LICENSE
South Carolina MEDICAID 1353044 MEDICAL LICENSE
South Carolina Other DR-35304 MEDICAL LICENSE
South Carolina Other 28950 MEDICAL LICENSE

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