Nine, Bradley
Nine, Bradley is an individual health care provider with primary practice located at 3200 Maccorkle Ave Se , Charleston WV 25304-1297. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Nine, Bradley can be contacted via phone (304) 388-5432.Contact Information
Primary practice address
3200 Maccorkle Ave Se
Charleston WV 25304-1297
Phone: (304) 388-5432
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 15916 | West Virginia |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 15916 | West Virginia |
Profile Details
| NPI number | 1053363127 |
|---|---|
| LBN Legal business name | Nine, Bradley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 17th, 2006 |
| Last updated | Oct 13th, 2023 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053363127 | NPPES |
| West Virginia | MEDICAID | 0075463000 | |
| West Virginia | Other | 00683538 | |
| West Virginia | MEDICAID | 0891003 | |
| West Virginia | Other | 3001160 | |
| West Virginia | MEDICAID | 64699267 |
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