Bradley, Michael

Bradley, Michael is an sole proprietor health care provider with primary practice located at 2450 Delaney Rd , Wilmington NC 28403-6062. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Bradley, Michael can be contacted via phone (910) 762-9083.

Contact Information

Primary practice address
2450 Delaney Rd Wilmington NC 28403-6062
Phone: (910) 762-9083
Fax: (910) 763-6339
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 977 North Carolina

Profile Details

NPI number 1750356515
LBN Legal business name Bradley, Michael
Credentials ED.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 22nd, 2006
Last updated Sep 11th, 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 1750356515 NPPES
North Carolina Other 071992 VALU OPTIONS
North Carolina MEDICAID 6000593 VALU OPTIONS
North Carolina Other 03457 VALU OPTIONS
North Carolina Other 126105 VALU OPTIONS

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