MICHAEL SCOTT BROAD (NPI# 1356380935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356380935 |
| Entity Type | Individual |
| Full Name | MICHAEL SCOTT BROAD |
| Credential | PA-C |
| Practice Address |
1555 South Blvd E Suite 310 Rochester Hills MI 48307-5605 |
| Mailing Address |
1635 Fairholme Rd Grosse Pointe Woods MI 48236-2368 |
| Practice Telephone | 2482158095 |
| Practice Fax Number | 2482891086 |
| Mailing Telephone | 3138825473 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2012-11-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
5601003846 | MI | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1555 SOUTH BLVD E SUITE 310 |
| City | ROCHESTER HILLS |
| State | MI |
| Zip Code | 48307-5605 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790766871 | Bradley D Ahlgren | Orthopaedic Surgery | 1555 South Blvd E, Suite 310, Rochester Hills, MI 48307-5605 | 2005-11-07 |
| 1194383547 | Megan Emily White | Nutritionist | 1555 South Blvd E, Rochester Hills, MI 48307-5605 | 2019-05-31 |
| 1366922411 | Melissa Marie Lachowicz | Nurse Practitioner | 1555 South Blvd E, Rochester Hills, MI 48307-5605 | 2018-08-17 |
| 1952801540 | Kelsey Lightner | Physical Therapist | 1555 South Blvd E, Rochester Hills, MI 48307-5605 | 2018-02-20 |
| 1154879989 | Vanessa Murad | Physician Assistant | 1555 South Blvd E, Rochester Hills, MI 48307-5605 | 2016-09-21 |
| 1194108308 | Arianne Lemon | Nurse Practitioner | 1555 South Blvd E, Rochester Hills, MI 48307-5605 | 2015-07-07 |
| 1972868321 | Michigan Orthopaedic Spine Surgeons PC | Orthopaedic Surgery | 1555 South Blvd E, Suite 310, Rochester Hills, MI 48307-5605 | 2012-07-11 |
| 1033404934 | Matthew Lawrence D'john | Orthopaedic Surgery | 1555 South Blvd E, Ste 310, Rochester Hills, MI 48307-5624 | 2011-06-20 |
| 1780819490 | Nathan Rimmke | Orthopaedic Surgery | 1555 South Blvd E, Suite 310, Rochester Hills, MI 48307-5605 | 2009-05-26 |
| 1356559744 | Christopher Hulen | Orthopaedic Surgery | 1555 South Blvd E, Suite 310, Rochester Hills, MI 48307-5605 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083238851 | Martin Dukaj | Student in an Organized Health Care Education/Training Program | 1101 Walton Blvd, Rochester Hills, MI 48307 | 2020-06-08 |
| 1073151973 | Cynthia Lynn Olekszyk | Dietitian, Registered | 645 Barclay Circle, Rochester Hills, MI 48307 | 2019-12-11 |
| 1326502428 | Jessica Delia | Nurse Practitioner | 1701 E South Boulevard, Suite 290, Rochester Hills, MI 48307 | 2019-01-23 |
| 1528530037 | Kelie Friday | Physical Therapist | 312 Rochester Hills, Dearborn, MI 48307 | 2018-12-21 |
| 1538635883 | Julie Latarewicz | Physical Therapist | Ascension Providence Rochester Hospital, 1101 West University Drive, Rochester, MI 48307 | 2018-10-15 |
| 1891270757 | Leah Marx | Social Worker | 3950 Rochester Rd, Ste 2250, Rochester Hills, MI 48307 | 2018-09-26 |
| 1598256729 | Frederick Alan Bittner | Student in an Organized Health Care Education/Training Program | 1101 W. University Drive, 3 North, Rochester, MI 48307 | 2018-05-23 |
| 1508356346 | Ankita Aggarwal | Student in an Organized Health Care Education/Training Program | Wsu/ascension Crittenton Hospital, 1101 W. University Drive, Rochester, MI 48307 | 2018-05-17 |
| 1619478195 | Michelle Nuccio | Occupational Therapist | 1555 E South Blvd, Rochester Hills, MI 48307 | 2018-02-21 |
| 1265932024 | Stacy Dietlin Linn | Physical Therapist | 1555 E. South Blvd, Suite 120, Rochester Hills, MI 48307 | 2018-02-19 |
| Find all providers in zip 48307 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407872096 | Lisa Anne Hypnar | Physician Assistant | 910 Dickson Ln, Rochester Hills, MI 48307-3336 | 2006-07-15 |
| 1295961696 | Eunice Heuvers | Physician Assistant | 1135 W University Dr, Suite 450, Rochester Hills, MI 48307-1871 | 2009-06-01 |
| 1730384306 | Meredith Ann Wood | Physician Assistant | 1135 W University Dr, Suite 450, Rochester Hills, MI 48307-1871 | 2007-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841835303 | Gerard M Lefebvre Jr. | Physician Assistant | 5301 Mcauley Dr Ste 5112, Ypsilanti, MI 48197-1051 | 2019-11-08 |
| 1548611023 | Michael Scott Schaeffer II | Physician Assistant | 58070 Montego Dr, New Hudson, MI 48165-9735 | 2016-06-27 |
| 1700248176 | Katilyn Kohl | Physician Assistant | 3990 John R St Ste 4905, Detroit, MI 48201-2018 | 2016-03-24 |
| 1881052363 | Surgical Assist, Plc | Physician Assistant | 4409 Gaylord Dr, Troy, MI 48098-4458 | 2016-01-29 |
| 1710342134 | Evan Reid Vandenbosch | Physician Assistant | 36622 5 Mile Rd, Suite 101, Livonia, MI 48154-1900 | 2015-12-30 |
| 1619368008 | Matthew Eisen | Physician Assistant | 1560 E Sherman Blvd Ste 9, Muskegon, MI 49444-1867 | 2015-02-06 |
| 1609214972 | Jennifer Lynn Krishnan | Physician Assistant | 3601 E 13 Mile Rd, Royal Oak, MI 48073-6769 | 2013-06-10 |
| 1093028441 | Lonna Petronella Van Ast | Physician Assistant | 1022 Ada Place Dr Se, Grand Rapids, MI 49546-3786 | 2010-07-14 |
| 1669707170 | Luke Thomas Dillon | Physician Assistant | 3100 Cross Creek Pkwy Ste 200, Auburn Hills, MI 48326-2776 | 2009-10-16 |
| 1912139544 | Richard Lawrence Burgett Sr. | Physician Assistant | 4327 Stone Ridge Dr, Traverse City, MI 49684-7958 | 2009-08-15 |
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| City | ROCHESTER HILLS |
| Zip Code | 48307 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.