Bradshaw, Brian R

Bradshaw, Brian R is an individual health care provider with primary practice located at 1055 N 500 W Suite 111, Provo UT 84604-3305. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Bradshaw, Brian R can be contacted via phone (801) 374-8999.

Contact Information

Primary practice address
1055 N 500 W Suite 111 Provo UT 84604-3305
Phone: (801) 374-8999
Fax: (801) 429-8063
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 2806031205 Utah

Profile Details

NPI number 1811955800
LBN Legal business name Bradshaw, Brian R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 2nd, 2006
Last updated Nov 27th, 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 1811955800 NPPES
Utah Other 03-00064 UNITED HEALTHCARE
Utah Other 36578 UNITED HEALTHCARE
Utah Other QM0000001619 UNITED HEALTHCARE
Utah Other 225984 UNITED HEALTHCARE
Utah Other 107006919101 UNITED HEALTHCARE
Utah Other 070008058 UNITED HEALTHCARE

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