Individual provider · NPI-1

Dr. Michelle A. Broderick, O.D.

Optometrist · Brunswick, ME

NPI number1003814096
StatusActive
Last updated in NPPESJul 13, 2026

Details

NPI
1003814096
Entity type
Individual (NPI-1)
Name
Dr. Michelle A. Broderick
Credential
O.D.
Sex
Female
Sole proprietor
No
Enumeration date
Jul 13, 2005
Last updated
Jul 13, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X OptometristOPT767MEYes

Practice location

82 Maine St
Brunswick, ME 04011-2015

Phone 207-729-8474 · Fax 207-729-8955

Mailing address

82 Maine St
Brunswick, ME 04011-2015

Phone 207-729-8474 · Fax 207-729-8955

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