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Individual
DR. TERESA J BRADLEY
Active
Individual
DR. TERESA J BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
95-01183
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8917808
—
NC
01
—
P01203020
MEDICARE RR
NC
Enumeration date
02/28/2006
Last updated
12/04/2020
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