Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ian Matthew Broussard, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1871024968

Ian Matthew Broussard, DO is an Emergency Medicine in Myrtle Beach, South Carolina. Graduated from William Carey University College of Osteopathic Medicine in 2017, 9 years ago. Practices with Crowley Emergency Group LLC, a 27-clinician group and accepts Medicare assignment. Licensed in South Carolina.

Years since qualifying
9
Trained at
William Carey University College of Osteopathic Medicine
Licensed in
SC
In the registry since
2017
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

809 82nd Pkwy Grand Strand Medical Center Gme Ofc
Myrtle Beach, SC 29572-4607
Phone: (843) 692-1752
Fax: (843) 692-1904
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence LL41064 (SC)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (SC)

Record details

NPI number1871024968
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedMarch 21, 2017
Last updated in NPPESJune 12, 2017
Mailing address809 82nd Pkwy, Grand Strand Medical Center Gme Office, Myrtle Beach, SC 29572-4607

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyEMERGENCY MEDICINE
Medical schoolWILLIAM CAREY UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduated 2017 (9 years in practice)
Group practice Crowley Emergency Group Llc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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