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Individual
DR. BRAD H LILLY
Active
Individual
DR. BRAD H LILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC004243L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
013746
HIGHMARK BLUE SHIELD
PA
01
—
0659158000
INDEPENCE BLUE CROSS
—
01
—
50003290
CAPITAL BLUE CROSS
—
Enumeration date
08/24/2006
Last updated
11/17/2009
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