# BRADLEY RENE MARTIN

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1487639456
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 89592 | SC | Yes |
| 207RC0200X | Critical Care Medicine (Internal Medicine) Physician | 89592 | SC | — |

## Other

- **Enumeration date:** 12/13/2005
- **Last updated:** 07/15/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0614884 | MEDICARE ID | OH |
| 05 | — | 0688788 | — | OH |
| 01 | — | MA0614881 | MEDICARE ID | OH |