Peters, Bradley Robert

Peters, Bradley Robert is an sole proprietor health care provider with primary practice located at 200 Oakside Ln Ste A, Canton GA 30114-6416. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Peters, Bradley Robert can be contacted via phone (770) 479-1945.

Contact Information

Primary practice address
200 Oakside Ln Ste A Canton GA 30114-6416
Phone: (770) 479-1945
Fax: (770) 479-1948
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 051890 Georgia
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 202673 New York
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 26644 Alabama

Profile Details

NPI number 1659374262
LBN Legal business name Peters, Bradley Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 27th, 2005
Last updated Nov 10th, 2016 - about 8 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 1659374262 NPPES
Georgia MEDICAID 000964268L

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