Bradley, Kevin
Bradley, Kevin is an individual health care provider with primary practice located at 3401 N Broad St , Philadelphia PA 19140-5103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Bradley, Kevin can be contacted via phone (215) 707-3133.Contact Information
Primary practice address
3401 N Broad St
Philadelphia PA 19140-5103
Phone: (215) 707-3133
Fax: (215) 717-3945
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | MD067035L | Pennsylvania |
Profile Details
| NPI number | 1053309096 |
|---|---|
| LBN Legal business name | Bradley, Kevin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053309096 | NPPES |
| Pennsylvania | MEDICAID | 00177725680006 |
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