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Organization
PETER S. BRADSHAW M.D.
Active
Organization
PETER S. BRADSHAW M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER SHEWELL BRADSHAW M.D. (OWNER)
(978) 459-3341
Entity
Organization
Contact information
Practice address
77 E MERRIMACK ST, SUITE 15, LOWELL, MA 01852-1251
(978) 459-3341
(978) 459-5344
Mailing address
77 E MERRIMACK ST, SUITE 15, LOWELL, MA 01852-1251
(978) 459-3341
(978) 459-5344
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2055074
—
MA
01
—
M17561
BLUE CROSS/BLUE SHIELD
MA
Enumeration date
09/04/2007
Last updated
09/04/2007
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