Individual
SAMUEL B BROADDUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
81 MEDICAL CENTER DR, SUITE 2350, BRUNSWICK, ME 04011-2764
(207) 373-6690
(207) 373-6695
Mailing address
81 MEDICAL CENTER DR, SUITE 2350, BRUNSWICK, ME 04011-2764
(207) 373-6690
(207) 373-6695
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD11648
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
263730099
—
ME
05
—
30007671
—
NH
Enumeration date
05/25/2006
Last updated
01/21/2015
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