Michael H. Broder, D.O.

Primary specialty

SpecialistTaxonomy code 174400000X

License

DO313 Issued in AL

Practice address

2034 Chestnut St
Montgomery, AL 36106-1111

Phone

(334) 269-0212

Fax

(334) 269-2144

NPI assigned

Jul 27, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bio-Medical Applications of Alabama, Inc.

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Montgomery, AL
  • NPI 1104568005
  NPD (past)
• Physicians Choice Dialysis of Selma, LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Selma, AL
  • NPI 1629144514
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1104830348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 CHESTNUT ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061111",
            "telephone_number": "334-269-0212",
            "fax_number": "334-269-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 CHESTNUT ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061111",
            "telephone_number": "334-269-0212",
            "fax_number": "334-269-2144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODER",
        "first_name": "MICHAEL",
        "middle_name": "H.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "AL",
            "license": "DO313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Broadfoot, SLP
• Ritchelle Broadnax, DNP,CRNP
• Mary Catherine Brock, CRNP, FNP-C
• Abigail Calametti Broder, M.D.
• Evan Broder, M.D.
• Madeline Ann Broming, MSN, RN, CPNP-PC
• Kaysie Bronson, CRNP
• Jennifer Anne Brookins, D.D.S
• Justine Diane Brookins, NP
• Lachandra Monet Brooks-Prim, LPC

• All providers in Montgomery, AL
• Specialist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.