Individual
STEPHANIE O. BRODERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4405 E 26TH ST, SIOUX FALLS, SD 57103-4187
(605) 328-9000
(605) 328-9001
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(605) 328-6585
(605) 328-6512
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4547
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5610682
—
SD
Enumeration date
06/15/2005
Last updated
03/31/2022
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