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Individual
BRADLEY J MAGILL
Active
Individual
BRADLEY J MAGILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC003260L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000090188
UNISON THREE RIVERS MEDPL
PA
05
—
0011362640005
—
PA
01
—
1035572
GATEWAY PA MEDICAID
PA
01
—
201856
UPMC
PA
01
—
364643
HIGHMARK BC BS PA
PA
Enumeration date
07/28/2006
Last updated
01/30/2019
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