Michael D Broadwell, PSYD is a
Psychologist based in Rochester, Minnesota. Michael D Broadwell is licensed to practice in Minnesota (license number LP6869) and his current practice location is
3535 40th Ave Nw Ste 210, Rochester, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(507) 516-0227.
NPI number for Michael D Broadwell is 1053645119 and his current mailing address is 3535 40th Ave Nw Ste 210, Rochester, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1053645119.
Healthcare Provider's Profile
| Full Name | Michael D Broadwell |
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| Gender | Male |
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| Speciality | Psychologist |
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| Location | 3535 40th Ave Nw Ste 210, Rochester, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1053645119
- Provider Enumeration Date: 09/22/2009
- Last Update Date: 12/12/2022
Medical Identifiers
Medical identifiers for Michael D Broadwell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053645119 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 103K00000X | Behavior Analyst | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | LP6869 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Michael D Broadwell is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Michael D Broadwell, PSYD
3535 40th Ave Nw Ste 210,
Rochester, MN 55901-1769
Ph: (507) 516-0227 | Michael D Broadwell, PSYD
3535 40th Ave Nw Ste 210,
Rochester, MN 55901-1769
Ph: (507) 516-0227 |
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