Individual
MR. MICHAEL PAUL BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 328-6704
(410) 328-4124
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 955-5000
(410) 500-4266
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R133503
MD
Other
Enumeration date
11/19/2007
Last updated
11/11/2025
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