Individual
SUZETTE BROSHEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
316 CHANDLER AVE, EVANSVILLE, IN 47713-1147
(812) 436-4501
(812) 436-4510
Mailing address
315 MULBERRY ST, EVANSVILLE, IN 47713-1252
(812) 421-7489
(812) 436-0209
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01049478
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000785906
ANTHEM BCBS
IN
01
—
200079040D
MEDICAID GRP
IN
05
—
200200690
—
IN
01
—
M400052567
MEDICARE
—
Enumeration date
11/09/2007
Last updated
08/19/2016
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