| Broadway Sports And Internal Medicine | |
|
1600 116th Ave Ne Suite 202 Bellevue WA 98004-3014 | |
| (206) 215-2288 | |
| (206) 215-2289 |
| Full Name | Broadway Sports And Internal Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 1600 116th Ave Ne, Bellevue, Washington |
| Authorized Official Name and Position | Gary Richard Schuster (PHYSICIAN) |
| Authorized Official Contact | 2062152288 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadway Sports And Internal Medicine 1600 116th Ave Ne Suite 202 Bellevue WA 98004-3014 Ph: (206) 215-2288 | Broadway Sports And Internal Medicine 1600 116th Ave Ne Suite 202 Bellevue WA 98004-3014 Ph: (206) 215-2288 |
| NPI Number | 1396803797 |
|---|---|
| Provider Enumeration Date | 12/05/2006 |
| Last Update Date | 11/04/2016 |
| Medicare PECOS PAC ID | 0042492944 |
|---|---|
| Medicare Enrollment ID | O20110315000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396803797 | NPI | - | NPPES |
| MD0019545 | Other | WA | WA STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | MD0019545 (Washington) | Secondary |
| 207R00000X | Internal Medicine | MD0019545 (Washington) | Primary |
| Provider Name | Gary R Schuster |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053500223 PECOS PAC ID: 0244126944 Enrollment ID: I20040227000231 |
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