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1790820710
BRUCE E BROADWATER
CUMBERLAND, MD
NPI
1790820710
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
163W00000X Registered Nurse
(Licence: MD R085498)
Enumeration Date
2007-02-20
Last Update Date
2007-07-08
Business Address
BRUCE E BROADWATER CRNA
924 SETON DR
CUMBERLAND, MD 21502-1851
Phone number: 301-724-0967
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Mailing Address
BRUCE E BROADWATER CRNA
10861 WESTERNPORT ROAD
FROSTBURG, MD 21532
Phone number: 301-463-2490
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