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Individual
JOHN SCOTT BRODERICK
Active
Individual
JOHN SCOTT BRODERICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
16584
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165840
—
SC
01
—
200032060
RR MEDICARE
SC
01
—
4460681
CIGNA
SC
01
—
5391725
AETNA
SC
01
—
576007863084
BCBS OF SC
SC
01
—
P00797721
RR MEDICARE
SC
Enumeration date
05/12/2006
Last updated
03/15/2023
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