Bradley, Mark Stephen
Bradley, Mark Stephen is an sole proprietor health care provider with primary practice located at 1925 Aspen Dr Ste 500B , Santa Fe NM 87505-5495. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Bradley, Mark Stephen can be contacted via phone (505) 466-2575.Contact Information
Primary practice address
1925 Aspen Dr Ste 500B
Santa Fe NM 87505-5495
Phone: (505) 466-2575
Fax: (505) 466-2575
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | 2002-0015 | New Mexico |
Profile Details
| NPI number | 1497786867 |
|---|---|
| LBN Legal business name | Bradley, Mark Stephen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 5th, 2006 |
| Last updated | Jul 26th, 2009 - about 17 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 | 1497786867 | NPPES |
| New Mexico | MEDICAID | 85327760 | |
| New Mexico | Other | NM400109 |
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