Canada, Robert Bradley

Canada, Robert Bradley is an individual health care provider with primary practice located at 1325 Eastmoreland Ave Ste 220 , Memphis TN 38104. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Canada, Robert Bradley can be contacted via phone (901) 866-8810.

Contact Information

Primary practice address
1325 Eastmoreland Ave Ste 220 Memphis TN 38104
Phone: (901) 866-8810
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 32002 Tennessee

Profile Details

NPI number 1033176250
LBN Legal business name Canada, Robert Bradley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Feb 1st, 2019 - about 6 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 1033176250 NPPES
Tennessee MEDICAID Q003696
Tennessee MEDICAID 1033176250
Tennessee MEDICAID 00122642
Tennessee MEDICAID 140694001
Tennessee MEDICAID 003181471A
Tennessee MEDICAID 7100458660

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