Bradley, David D
Bradley, David D is an individual health care provider with primary practice located at Essentia Health South University Clinic 1702 University Drive South, Fargo ND 58103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Bradley, David D can be contacted via phone (701) 364-3300.Contact Information
Primary practice address
Essentia Health South University Clinic 1702 University Drive South
Fargo ND 58103
Phone: (701) 364-3300
Fax: (701) 364-8906
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 52167 | Minnesota |
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | PT14574 | North Dakota |
| Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation | 208100000X | 14574 | North Dakota |
Profile Details
| NPI number | 1639294259 |
|---|---|
| LBN Legal business name | Bradley, David D |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 20th, 2007 |
| Last updated | Mar 26th, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639294259 | NPPES |
| Minnesota | MEDICAID | 864638100 |
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