Individual
DR. BRADLEY JAMES BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4140 FERNCREEK DR, SUITE 801, FAYETTEVILLE, NC 28314-2563
(910) 484-2171
(910) 484-4568
Mailing address
4140 FERNCREEK DR, SUITE 801, FAYETTEVILLE, NC 28314-2563
(910) 484-2171
(910) 484-4568
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
9600467
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18801
BCBS INDIVIDUAL ID NUMBER
NC
05
—
8918801
—
NC
Enumeration date
02/17/2006
Last updated
07/01/2025
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