DR. WALLACE BROADBENT D.O.
NPI 1861443202
Emergency Medicine in Kalamazoo, MI

Active since May 12, 2006
1535 GULL RD, MSB 015, KALAMAZOO, MI 49048(269) 226-6933(269) 226-6949 Get Directions Write a Review

NPPES record last updated: February 10, 2009. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Wallace Broadbent D.o. NPPES

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

DR. WALLACE BROADBENT D.O. (NPI 1861443202) is an individual emergency medicine provider in Kalamazoo, Michigan, licensed in Michigan (5101011784) and active in the NPI registry since May 2006.

NPPES Registry Identity

NPI1861443202
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. WALLACE BROADBENTCredential: D.O.
Location Address1535 GULL RD, MSB 015Kalamazoo, MI 49048-1650
Mailing Address1535 Gull Rd, Msb 015Kalamazoo, MI 49048-1650 · (269) 226-6933 · Fax (269) 226-6949
Fax(269) 226-6949
Sole ProprietorNo
Enumeration DateMay 12, 2006
Last NPPES UpdateFebruary 10, 2009
NPI 1861443202 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License Licensed in MI · 5101011784
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Also ListedGeneral PracticeTaxonomy 208D00000X · License 5101011784 (MI)
1535 GULL RD, Kalamazoo, MI 49048

Other Identifiers 10

Other3123256-11MI · Medicaid - Three Rivers
Medicare ID-Type UnspecifiedG56008108MI · Three Rivers Health
Medicare PINC96038036MI
OtherWB011784MI · Blue Cross Blue Shield
Medicaid114572856MI
Medicare PIN0M90900031MI
Medicare OSCAR/certification230015MI
Other700G560080MI · Bcbs Group-three Rivers Health
Medicare PIN930027746MI
Medicare UPINF52248MI

Other Providers at the Same Location NPPES 20

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

Emergency Medicine
1535 GULL RD, MSB 015
KALAMAZOO, MI 49048
Internal Medicine (Gastroenterology)
1535 GULL RD, SUITE 105
KALAMAZOO, MI 49048
Family Medicine (Sleep Medicine)
1535 GULL RD
KALAMAZOO, MI 49048
Emergency Medicine
1535 GULL RD, MSB 015
KALAMAZOO, MI 49048
Internal Medicine (Pulmonary Disease)
1535 GULL RD, STE 130
KALAMAZOO, MI 49048
Radiology (Body Imaging)
1535 GULL RD, SUITE 200
KALAMAZOO, MI 49048
Emergency Medicine
1535 GULL RD, MSB 015
KALAMAZOO, MI 49048
Radiology (Neuroradiology)
1535 GULL RD, SUITE #200
KALAMAZOO, MI 49048

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 Wallace Broadbent's NPI number?

The NPI number for Wallace Broadbent is 1861443202. It was assigned to this individual provider in the NPPES registry on May 12, 2006.

Where is Wallace Broadbent located?

Wallace Broadbent practices at 1535 Gull Rd Msb 015, Kalamazoo, MI 49048. The listed phone number is (269) 226-6933.

What is Wallace Broadbent's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

When was this NPI record last updated?

The NPPES record for Wallace Broadbent was last updated on February 10, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.