Individual
RONALD A BROADWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 ELECTRIC RD, SALEM, VA 24153-7474
(540) 776-4055
Mailing address
PO BOX 12668, ROANOKE, VA 24027-2668
(540) 981-7553
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101050828
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007221151
—
VA
Enumeration date
06/11/2006
Last updated
08/13/2013
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