MEDICARE: MARC S. BROADWAY B.A., SAA

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	4455	NM

General Provider Information

NPI Number	:	1043342496
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC S. BROADWAY B.A., SAA

Provider Business Mailing Address
First Line	:	2011 TROY KING RD TRLR 10
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87401-3123
Country	:	US
Telephone Number	:	505-566-0336
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 TROY KING RD TRLR 10
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87401-3123
Country	:	US
Telephone Number	:	505-566-0336
Fax Number	:

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

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1932115235 — APEX DRUG STORES INC
Practice Location Address:

35584 GRAND RIVER AVENUE
FARMINGTON HILLS, MI
48335-3123

Practice Phone: 248-474-1717
Practice Fax:

1639454333 — DR. DANIEL EDWARD RICE JR. CRNA
Practice Location Address:

168 BAY RD
FARMINGTON, NH
03835-3123

Practice Phone: 334-318-6537
Practice Fax:

1902174204 — DR. NATALIE MARIE NEDANOVSKI D.O.
Practice Location Address:

33225 GRAND RIVER AVE
FARMINGTON, MI
48336-3123

Practice Phone: 248-767-8732
Practice Fax:

1194095646 — ESSENTIAL FAMILY CHIROPRACTIC
Practice Location Address:

33225 GRAND RIVER AVE
FARMINGTON, MI
48336-3123

Practice Phone: 248-767-8732
Practice Fax: 248-477-1052

1366882557 — NATALIE CATT CMT
Practice Location Address:

35560 GRAND RIVER AVE , SUITE 225
FARMINGTON HILLS, MI
48335-3123

Practice Phone: 734-276-3424
Practice Fax: 248-957-8356

1275959413 — MRS. HEATHER JAMES
Practice Location Address:

35560 GRAND RIVER AVE , SUITE 225
FARMINGTON HILLS, MI
48335-3123

Practice Phone: 734-276-3424
Practice Fax:

Directions to “ MARC S. BROADWAY B.A., SAA” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.