Maxwell, Bradley J

Maxwell, Bradley J is an individual health care provider with primary practice located at 2701 N Decatur Rd , Decatur GA 30033-5918. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as his primary health care specialty. Maxwell, Bradley J can be contacted via phone (678) 514-1991.

Contact Information

Primary practice address
2701 N Decatur Rd Decatur GA 30033-5918
Phone: (678) 514-1991
Fax: (678) 514-1992
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 003166 Georgia

Profile Details

NPI number 1104866250
LBN Legal business name Maxwell, Bradley J
Credentials PAA
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Feb 20th, 2013 - 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 1104866250 NPPES
Georgia MEDICAID 100002306A

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