Individual
DR. SHERRI MARIE BROADWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3622 MAIN ST, COLLEGE PARK, GA 30337-2721
(404) 458-0382
Mailing address
3622 MAIN ST, COLLEGE PARK, GA 30337-2721
(404) 458-0382
(678) 335-2480
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
67942
GA
2084P0804X
Child & Adolescent Psychiatry Physician
M7633
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194238504
—
TX
Enumeration date
09/13/2007
Last updated
02/19/2024
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