Bradshaw, Todd M.

Bradshaw, Todd M. is an individual health care provider with primary practice located at 225 Memorial Dr Ste 1200 , Berlin WI 54923-1243. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Bradshaw, Todd M. can be contacted via phone (920) 361-5770.

Contact Information

Primary practice address
225 Memorial Dr Ste 1200 Berlin WI 54923-1243
Phone: (920) 361-5770
Fax: (920) 361-5779
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 36541-020 Wisconsin
Allopathic & Osteopathic Physicians / Surgery 208600000X 36541-020 Wisconsin

Profile Details

NPI number 1518968460
LBN Legal business name Bradshaw, Todd M.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Oct 24th, 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 1518968460 NPPES
Wisconsin MEDICAID 32152000

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