| Dr Wallace Broadbent, DO | |
|
1535 Gull Rd, Msb 015, Kalamazoo, MI 49048-1650 | |
| (269) 226-6933 | |
| (269) 226-6949 |
| Full Name | Dr Wallace Broadbent |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 1535 Gull Rd, Kalamazoo, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861443202 | NPI | - | NPPES |
| 3123256-11 | Other | MI | MEDICAID - THREE RIVERS |
| 700G560080 | Other | MI | BCBS GROUP-THREE RIVERS HEALTH |
| WB011784 | Other | MI | BLUE CROSS BLUE SHIELD |
| 114572856 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 5101011784 (Michigan) | Primary |
| 208D00000X | General Practice | 5101011784 (Michigan) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Wallace Broadbent, DO 1535 Gull Rd, Msb 015, Kalamazoo, MI 49048-1650 Ph: (269) 226-6933 | Dr Wallace Broadbent, DO 1535 Gull Rd, Msb 015, Kalamazoo, MI 49048-1650 Ph: (269) 226-6933 |
Nicole Catherine Carpp, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 125 S Kalamazoo Mall Ste 204, Kalamazoo, MI 49007 Phone: 269-343-3900 | |
Dr. Brannon Charles Duncan, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1850 Whites Rd, Suite 3, Kalamazoo, MI 49008 Phone: 269-343-3900 Fax: 269-343-5640 | |
Abigail Munro Bond, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Oakland Dr, Kalamazoo, MI 49008 Phone: 269-337-6600 Fax: 269-337-6475 | |
Dr. Charles Moore, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1535 Gull Rd, Msb 015, Kalamazoo, MI 49048 Phone: 269-226-6933 Fax: 269-226-6949 | |
Dr. Jonathan Ross Dadurian, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 125 S Kalamazoo Mall, Ste 204, Kalamazoo, MI 49007 Phone: 269-343-3900 | |
Jason Andrew Garner, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1000 Oakland Dr, Kalamazoo, MI 49008 Phone: 269-337-6600 Fax: 269-337-6475 | |
Nicholas Dyga, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 125 S Kalamazoo Mall Ste 204, Kalamazoo, MI 49007 Phone: 269-343-3900 |