Bradley, Angie S

Bradley, Angie S is an individual health care provider with primary practice located at 1505 Stonebridge Parkway Suite 200, Woodstock GA 30189. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Bradley, Angie S can be contacted via phone (770) 926-9112.

Contact Information

Primary practice address
1505 Stonebridge Parkway Suite 200 Woodstock GA 30189
Phone: (770) 926-9112
Fax: (770) 926-8240
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 006885 Georgia

Profile Details

NPI number 1811322340
LBN Legal business name Bradley, Angie S
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2013
Last updated Jan 31st, 2014 - about 11 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 1811322340 NPPES
Georgia Other 202I971251 MEDICARE PTAN

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