Bradley, Edward Michael

Bradley, Edward Michael is an individual health care provider with primary practice located at 900 N. 1St Street , Springfield IL 62702-3749. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Bradley, Edward Michael can be contacted via phone (217) 528-7541.

Contact Information

Primary practice address
900 N. 1St Street Springfield IL 62702-3749
Phone: (217) 528-7541
Fax: (217) 525-1007
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 036063765 Illinois

Profile Details

NPI number 1497744171
LBN Legal business name Bradley, Edward Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Jul 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 1497744171 NPPES
Illinois MEDICAID 036063765

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