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NPI Code Detail

MEDICARE: MRS. REBECCA BROSCHART D.O.

MEDICARE: MRS. REBECCA BROSCHART D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician053105GA

General Provider Information

NPI Number : 1205824869
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. REBECCA BROSCHART D.O.
Provider Business Mailing Address
First Line : 5671 N SKEEL AVE
Second Line :
City : OSCODA
State : MI
Zip : 48750-1535
Country : US
Telephone Number : 989-739-2550
Fax Number :
Provider Business Practice Location Address
First Line : 208 S STATE ST
Second Line :
City : OSCODA
State : MI
Zip : 48750-1642
Country : US
Telephone Number : 989-739-2550
Fax Number : 989-358-3750
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/07/2005
Last Update Date : 05/19/2022

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Directions to “ MRS. REBECCA BROSCHART D.O.” Practice Location

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