Peterson, Bradley A

Peterson, Bradley A is an individual health care provider with primary practice located at 611 W. Park Street Emergency Medicine, Urbana IL 61801. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Peterson, Bradley A can be contacted via phone (217) 383-3313.

Contact Information

Primary practice address
611 W. Park Street Emergency Medicine Urbana IL 61801
Phone: (217) 383-3313
Fax: (217) 383-4014
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036109503 Illinois

Profile Details

NPI number 1730145269
LBN Legal business name Peterson, Bradley A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2006
Last updated May 8th, 2014 - about 10 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 1730145269 NPPES
Illinois MEDICAID 036-109503

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