Organization
BROADWAY MEDICAL TREATMENT CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER GEORGE BRASSARD M.D. (PHYSICIAN / OWNER)
(401) 438-5551
Entity
Organization
Contact information
Practice address
1053 S BROADWAY, EAST PROVIDENCE, RI 02914-4729
(401) 438-5551
(401) 438-7272
Mailing address
1053 S BROADWAY, EAST PROVIDENCE, RI 02914-4729
(401) 438-5551
(401) 438-7272
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
CMD 06972
RI
Other
Enumeration date
09/04/2007
Last updated
09/04/2007
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