Bradshaw, Todd M.
Bradshaw, Todd M. is an individual health care provider with primary practice located at 225 Memorial Dr Ste 1200 , Berlin WI 54923-1243. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Bradshaw, Todd M. can be contacted via phone (920) 361-5770.Contact Information
Primary practice address
225 Memorial Dr Ste 1200
Berlin WI 54923-1243
Phone: (920) 361-5770
Fax: (920) 361-5779
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 36541-020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 36541-020 | Wisconsin |
Profile Details
| NPI number | 1518968460 |
|---|---|
| LBN Legal business name | Bradshaw, Todd M. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 2nd, 2005 |
| Last updated | Oct 24th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1518968460 | NPPES |
| Wisconsin | MEDICAID | 32152000 |
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