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Contact Information

CHARLES BROADWAY
1109 JONES ST
KENNETT, MO63857-3824
 Phone: 573-888-6545
 Fax: 573-888-2369
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community Health Worker

172V00000X
Indicates primary specialty

NPI Profile & details for CHARLES BROADWAY · (Male)

NPI Number 1932331907
Status Active
Credentials
Entity Individual
Enumeration date 08/10/2009
Last updated 08/10/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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