Anderson, Bradley Myren

Anderson, Bradley Myren is an individual health care provider with primary practice located at 2055 15Th St N , Saint Cloud MN 56303-1747. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Anderson, Bradley Myren can be contacted via phone (320) 251-1432.

Contact Information

Primary practice address
2055 15Th St N Saint Cloud MN 56303-1747
Phone: (320) 251-1432
Fax: (320) 251-7122
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 43592 Minnesota

Profile Details

NPI number 1548258221
LBN Legal business name Anderson, Bradley Myren
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 7th, 2005
Last updated Feb 20th, 2012 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548258221 NPPES
Minnesota Other 08-01106 MEDICA
Minnesota MEDICAID 527444300 MEDICA
Minnesota Other P00134021 MEDICA
Minnesota Other 441T6AN MEDICA

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