Individual
DR. JOSEPH BENJAMIN BROUDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(809) 776-4000
Mailing address
200 ATRIUM WAY, APT. 1305, COLUMBIA, SC 29223-6390
(859) 420-2770
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
57.012530
OH
2085R0204X
Vascular & Interventional Radiology Physician
2011015956
MO
2085R0204X
Vascular & Interventional Radiology Physician
Primary
25MA09179300
NJ
Other
Enumeration date
03/09/2007
Last updated
09/15/2012
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