Gore, Bradley Kevin

Gore, Bradley Kevin is an individual health care provider with primary practice located at 9430 Forestwood Lane Suite 100, Manassas VA 20110. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Gore, Bradley Kevin can be contacted via phone (703) 365-0227.

Contact Information

Primary practice address
9430 Forestwood Lane Suite 100 Manassas VA 20110
Phone: (703) 365-0227
Fax: (703) 365-0332
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 26427 Kentucky
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 0101246204 Virginia

Profile Details

NPI number 1265491526
LBN Legal business name Gore, Bradley Kevin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 23rd, 2006
Last updated Dec 14th, 2009 - about 15 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 1265491526 NPPES
Virginia MEDICAID 1265491526

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