Individual
MR. MICHAEL J. MCBROOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
210 E DERENNE AVE, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5260
Mailing address
460 MALL BLVD, SUITE B, SAVANNAH, GA 31406-4801
(912) 644-5300
(912) 644-5260
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
003073
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100002603A
—
GA
Enumeration date
04/26/2006
Last updated
01/13/2017
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