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Individual
DR. BRADLY SCOTT SHOLLENBERGER
Active
Individual
DR. BRADLY SCOTT SHOLLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002902L
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
SC002902L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020421000
KHPE
PA
05
—
011820330007
—
PA
01
—
01328801
BLUE CROSS
PA
01
—
0522660000
KHPE
PA
01
—
116509
MED PLUS
PA
01
—
31854
MERCY
PA
01
—
688055
BLUE SHIELD
PA
01
—
7990970
GATEWAY
PA
Enumeration date
11/05/2005
Last updated
11/02/2007
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