Lineback, Bradley

Lineback, Bradley is an individual health care provider with primary practice located at 8016 Myrtle Trace Dr , Conway SC 29526-8945. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Lineback, Bradley can be contacted via phone (843) 347-7266.

Contact Information

Primary practice address
8016 Myrtle Trace Dr Conway SC 29526-8945
Phone: (843) 347-7266
Fax: (843) 347-2130
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 11902 South Carolina

Profile Details

NPI number 1841390192
LBN Legal business name Lineback, Bradley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2006
Last updated Oct 4th, 2016 - about 10 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1841390192 NPPES
South Carolina MEDICAID 119026
South Carolina MEDICAID GP4505

Popular Providers