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General NPI Number Information
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NPI Number | 1528317815
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Entity Type | Organization
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Legal Business Name | BROADVIEW HEALTH, PA
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Dates
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Enumeration Date | 09/03/2012
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Last Update Date | 08/26/2021
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Provider Practice Location Address
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Address Line | 349 VENUS ST
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City | MONROE
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State | NC
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Zip | 28112-4025
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Country | US
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Telephone | 704-635-7418
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Fax | 704-635-7500
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Provider Business Mailing Address
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Address Line | 200 E JEFFERSON ST
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City | MONROE
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State | NC
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Zip | 28112-4863
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Country | US
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Telephone | 336-354-6126
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RASHEED ADEYINKA ONAFUYE
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Credential | M.D
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Telephone | 336-354-6126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number | 2009-00832
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License Number State | NC
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