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Individual
BRADLEY D DAVEY
Active
Individual
BRADLEY D DAVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-AA
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
003698
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100001125A
PEACHSTATE CMO - MCCG
GA
05
—
100001125A
—
GA
01
—
344298
WELLCARE CMO - MCCG
GA
Enumeration date
05/01/2007
Last updated
11/17/2014
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