| Dr Tara L Broadwater, MD | |
|
898 Wescott Trl Apt 311, Eagan, MN 55123-2272 | |
| (507) 304-1899 | |
| Not Available |
| Full Name | Dr Tara L Broadwater |
|---|---|
| Gender | Female |
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 898 Wescott Trl Apt 311, Eagan, Minnesota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255310298 | NPI | - | NPPES |
| 388R8BU | Other | MN | BCBS |
| 0573816 | Other | IA | MEDICAID |
| NA2951032151 | Other | MN | PREFFERED ONE |
| HP36174 | Other | MN | HEALTH PARTNERS |
| 1965380 | Other | MN | AMERICAS PPO |
| 124673 | Other | MN | UCARE |
| 41084933956001C212 | Other | CHAMPUS | |
| 526011600 | Medicaid | MN | |
| P00138242 | Other | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 40655 (Minnesota) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 40655 (Minnesota) | Primary |
| Entity Name | Sanford Health Of Northern Minnesota |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770849697 PECOS PAC ID: 5597725168 Enrollment ID: O20041025000442 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tara L Broadwater, MD 898 Wescott Trl Apt 311, Eagan, MN 55123-2272 Ph: (507) 304-1899 | Dr Tara L Broadwater, MD 898 Wescott Trl Apt 311, Eagan, MN 55123-2272 Ph: (507) 304-1899 |
Mark Patrick Kerekes, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1185 Town Centre Dr, Suite 225 Bhsi Llc, Eagan, MN 55123 Phone: 651-769-6200 Fax: 651-769-6249 | |
Dr. Benjamin Lane Hersey, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1110 Yankee Doodle Rd, Eagan, MN 55121 Phone: 651-454-3970 Fax: 651-241-0059 | |
Dr. Melvina Deneal Bissonette, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 860 Blue Gentian Rd Ste 200, Eagan, MN 55121 Phone: 612-217-1737 Fax: 612-457-0383 | |
Michael Anders Donndelinger Beldon, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 3450 Oleary Ln, Eagan, MN 55123 Phone: 651-454-0114 | |
Bryan J Schwieters, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 2781 Pilot Knob Rd, Eagan, MN 55121 Phone: 651-289-7300 Fax: 651-289-7301 | |
John Robert Shirriff, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 3460 Washington Drive, Suite 200, Eagan, MN 55122 Phone: 651-769-6200 Fax: 651-769-6249 |