Broderick, Paul Eugene
Broderick, Paul Eugene is an sole proprietor health care provider with primary practice located at 1215 Hadley Rd Ste 206 , Mooresville IN 46158-2905. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Broderick, Paul Eugene can be contacted via phone (317) 834-1919.Contact Information
Primary practice address
1215 Hadley Rd Ste 206
Mooresville IN 46158-2905
Phone: (317) 834-1919
Fax: (317) 834-1920
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Colon & Rectal Surgery | 208C00000X | 02001623A | Indiana |
Profile Details
| NPI number | 1467459958 |
|---|---|
| LBN Legal business name | Broderick, Paul Eugene |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Apr 14th, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467459958 | NPPES |
| Indiana | Other | 000000095924 | ANTHEM |
| Indiana | Other | MEDICARE | ANTHEM |
| Indiana | MEDICAID | 200037350 | ANTHEM |
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