RONALD L. BROADWATER SR. M.D.PA
NPI 1497051395
Clinic/Center - Primary Care in Cockeysville, MD

Q: What is Ronald L. Broadwater Sr. M.D.Pa's NPI number?

The NPI number for Ronald L. Broadwater Sr. M.D.Pa is 1497051395. It was assigned to this organization in the NPPES registry on February 10, 2011.

Q: What is Ronald L. Broadwater Sr. M.D.Pa's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Active since February 10, 2011

12 BRECON PL, SUITE 400, COCKEYSVILLE, MD 21030(443) 281-8086(443) 281-8117 Get Directions Write a Review

NPPES record last updated: March 6, 2014. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ronald L. Broadwater Sr. M.d.pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RONALD L. BROADWATER SR. M.D.PA (NPI 1497051395) is a healthcare organization registered as a primary care in Cockeysville, Maryland and active in the NPI registry since February 2011. The organization lists Ronald Lee Broadwater, Owner/medical Provider, as its authorized official.

NPPES Registry Identity

NPI1497051395

Entity TypeOrganization

Primary Taxonomy261QP2300X

Legal Business NameRONALD L. BROADWATER SR. M.D.PA

Location Address12 BRECON PL, SUITE 400Cockeysville, MD 21030-2343

Mailing Address12 Brecon Pl, Suite 400Cockeysville, MD 21030-2343 · (443) 281-8086 · Fax (443) 281-8117

Phone(443) 281-8086

Fax(443) 281-8117

Organization SubpartNo

Authorized OfficialRonald Lee BroadwaterOwner/medical Provider · (443) 281-8086

Enumeration DateFebruary 10, 2011

Last NPPES UpdateMarch 6, 2014

✔ NPI 1497051395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities

Taxonomy Code261QP2300X

License✔ Licensed in MD · D15200

12 BRECON PL, Cockeysville, MD 21030

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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RICHARD G D'ANTONIO M.D.

Internal Medicine

12 BRECON PL, STE. 410
COCKEYSVILLE, MD 21030

Baltimore County (410) 825-3416

MR. RONALD LEE BROADWATER SR. MD

Family Medicine

12 BRECON PL, STE 400
COCKEYSVILLE, MD 21030

Baltimore County (443) 281-8086

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ronald L. Broadwater Sr. M.D.Pa's NPI number?

The NPI number for Ronald L. Broadwater Sr. M.D.Pa is 1497051395. It was assigned to this organization in the NPPES registry on February 10, 2011.

Where is Ronald L. Broadwater Sr. M.D.Pa located?

Ronald L. Broadwater Sr. M.D.Pa is located at 12 Brecon Pl Suite 400, Cockeysville, MD 21030. The listed phone number is (443) 281-8086.

What is Ronald L. Broadwater Sr. M.D.Pa's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Ronald L. Broadwater Sr. M.D.Pa was last updated on March 6, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.