Bradford, Shayne D

Bradford, Shayne D is an individual health care provider with primary practice located at 7505 Osler Dr Suite 506, Towson MD 21204-7736. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Bradford, Shayne D can be contacted via phone (410) 581-1600.

Contact Information

Primary practice address
7505 Osler Dr Suite 506 Towson MD 21204-7736
Phone: (410) 581-1600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X C0001923 Maryland

Profile Details

NPI number 1841251386
LBN Legal business name Bradford, Shayne D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated May 6th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1841251386 NPPES
Maryland Other CN6601 R/R MEDICARE GROUP #
Maryland Other 970005969 R/R MEDICARE GROUP #

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