MEDICARE: CATHERINE SCHREI BROADT DO

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
1	207Q00000X	Family Medicine Physician	OS008457L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366449191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE SCHREI BROADT DO

Provider Business Mailing Address
First Line	:	4059 JANDY BLVD
Second Line	:	SUITE 103
City	:	NAZARETH
State	:	PA
Zip	:	18064-2167
Country	:	US
Telephone Number	:	484-503-6450
Fax Number	:	484-503-6445

Provider Business Practice Location Address
First Line	:	4059 JANDY BLVD STE 103
Second Line	:
City	:	NAZARETH
State	:	PA
Zip	:	18064-8893
Country	:	US
Telephone Number	:	610-759-1200
Fax Number	:	610-759-4590

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/21/2022

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