Champagne, Bradley J

Champagne, Bradley J is an individual health care provider with primary practice located at 11100 Eudlid Avenue , Cleveland OH 44106. He recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as his primary health care specialty. Champagne, Bradley J can be contacted via phone (216) 844-7874.

Contact Information

Primary practice address
11100 Eudlid Avenue Cleveland OH 44106
Phone: (216) 844-7874
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 056041 Georgia

Profile Details

NPI number 1154357085
LBN Legal business name Champagne, Bradley J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Jan 13th, 2010 - about 16 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 1154357085 NPPES
Nebraska MEDICAID 10025555600
Nebraska MEDICAID 2681021
Nebraska Other P00385103
Nebraska Other 363406
Nebraska Other 745528
Nebraska Other 000000221043
Nebraska Other 000000503701
Nebraska Other 056041
Nebraska Other 7396822

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