Bradway, Marcella W

Bradway, Marcella W is an sole proprietor health care provider with primary practice located at 777 North St Suite 605, Pittsfield MA 01201-4147. She recently has only one registered license in Allopathic & Osteopathic Physicians / Colon & Rectal Surgery, which is considered as her primary health care specialty. Bradway, Marcella W can be contacted via phone (413) 447-2745.

Contact Information

Primary practice address
777 North St Suite 605 Pittsfield MA 01201-4147
Phone: (413) 447-2745
Fax: (413) 346-6703
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Colon & Rectal Surgery 208C00000X 037814 Connecticut

Profile Details

NPI number 1669478657
LBN Legal business name Bradway, Marcella W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 23rd, 2005
Last updated Jun 26th, 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 1669478657 NPPES
Connecticut MEDICAID 001378141

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