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Ian Matthew Broussard, DO
Emergency Medicine Physician in Myrtle Beach, South Carolina
NPI 1871024968

Ian Matthew Broussard is a Emergency Medicine Physician based in Myrtle Beach, SC. Ian Matthew Broussard practices in Myrtle Beach, SC and has the professional credentials of DO. The NPI Number for Ian Matthew Broussard is 1871024968 and holds a License No. (South Carolina).

The current practice location address for Ian Matthew Broussard is 809 82Nd Pkwy, Myrtle Beach, SC and can be reached out via phone at 843-692-1752 and via fax at 843-692-1904.

Location: 809 82Nd Pkwy, Myrtle Beach, SC, 29572-4607
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871024968
Provider Name
Ian Matthew Broussard
Credential
DO
Provider Entity Type
Individual
Gender
Male
Address
809 82Nd Pkwy, Myrtle Beach, SC, 29572-4607
Phone Number
843-692-1752
Fax Number
843-692-1904
Provider Enumeration Date
03/21/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
809 82Nd Pkwy
City
Myrtle Beach
State
South Carolina
Zip
29572-4607
Phone Number
843-692-1752
Fax Number
843-692-1904
person
Provider Business Mailing Address Details
Address
809 82Nd Pkwy
City
Myrtle Beach
State
South Carolina
Zip
29572-4607
Phone Number
843-692-1752
Fax Number
843-692-1904
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Emergency Medicine
Speciality
-
Taxonomy
207P00000X
License No.
LL41064 (South Carolina)
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.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
(South Carolina)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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