Dr. Devin Reese Broadwater, M.D.
Pathology, Anatomic Pathology & Clinical Pathology in Slidell, LA. Individual provider (NPI-1).
Details
- NPI
- 1609301779
- Entity type
- Individual (NPI-1)
- Name
- Dr. Devin Reese Broadwater
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 26, 2017
- Certification date
- Oct 2, 2025
- Last updated
- Oct 2, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PATHOLOGY
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 343754 | LA | Yes |
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | 29686 | MS | |
| 208D00000X | General Practice | 31052 | NE |
Practice location
1001 Gause BlvdSlidell, LA 70458-2987
Phone 985-280-2200
Mailing address
1514 Jefferson HwyNew Orleans, LA 70121-2429
Phone 504-842-3000
Other practice locations
Saushec Pathology Residency Program
Jbsa Ft Sam Houston, TX 78234-4504
Phone 210-916-6807
Biloxi, MS 39530-4130
Phone 228-432-1571 · Fax 419-866-5453
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 7 Anatomic Pathology & Clinical Pathology Physician providers in Slidell · All 2,622 providers in Slidell
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