Bradford, Velma Susan

Bradford, Velma Susan is an individual health care provider with primary practice located at 8610 W Overland Rd , Boise ID 83709-1645. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Bradford, Velma Susan can be contacted via phone (208) 954-8711.

Contact Information

Primary practice address
8610 W Overland Rd Boise ID 83709-1645
Phone: (208) 954-8711
Fax: (208) 375-2217
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X M7541 Idaho
Allopathic & Osteopathic Physicians / Pediatrics 208000000X M-7541 Idaho

Profile Details

NPI number 1629070636
LBN Legal business name Bradford, Velma Susan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 10th, 2005
Last updated Dec 15th, 2023 - about 2 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 1629070636 NPPES
Idaho MEDICAID 805219300
Idaho MEDICAID 1629070636

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