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Individual
BRADLEY MARK CEREMUGA
Active
Individual
BRADLEY MARK CEREMUGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
37663
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376630
—
SC
01
—
SCM9985019
MEDICARE PIN
SC
Enumeration date
07/10/2015
Last updated
03/25/2024
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