Whitty Bradley, Lisa Ann
Whitty Bradley, Lisa Ann is an sole proprietor health care provider with primary practice located at 7905 Calumet Ave , Munster IN 46321-2549. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery is her primary health care specialty. Whitty Bradley, Lisa Ann can be contacted via phone (219) 836-7506.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | 01079522B | Indiana |
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 01079522A | Indiana |
Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 01079522A | Indiana |
Profile Details
NPI number | 1801808662 |
---|---|
LBN Legal business name | Whitty Bradley, Lisa Ann |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Aug 12th, 2006 |
Last updated | Mar 16th, 2021 - about 3 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 | 1801808662 | NPPES |
Illinois | MEDICAID | 0361102441 | |
Illinois | Other | 7215166 |
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