Elisabeth Brodeur, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301107214 Issued in MI

Practice address

1 Genesys Pkwy
Ste 4595
Grand Blanc, MI 48439-8065

Phone

(810) 606-5126

NPI assigned

May 29, 2015

Sex

Female

Sole proprietor

Yes

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 Medicine

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1679952196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "address_2": "STE 4595",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 GENESYS PKWY",
            "address_2": "STE 4595",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484398065",
            "telephone_number": "810-606-5126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODEUR",
        "first_name": "ELISABETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-29",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301107214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Briggs, DO
• Brighter Visions Therapy & Family Counseling PLLC
• Todd Britt, DO
• William Brockmon
• Sidney M Broder, M.D.
• Nur Fatimah Bromund
• Christina Marie Brooks, FNP-C
• Natalie E Brooks, AUD
• Steven Dwight Brooks, D.O.
• Alexis Brophy, AUD

• Family Medicine Physician in Grand Blanc, MI
• Providers in Grand Blanc, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.