# DR. BRADLEY WHITAKER

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

## Provider details

- **NPI number:** 1821089624
- **Gender:** Man
- **Credential:** DPM., FACFAS

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 0446 | AZ | Yes |

## Other

- **Enumeration date:** 10/31/2005
- **Last updated:** 12/10/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1Z3482 | HEALTH NET | AZ |
| 05 | — | 337627 | — | AZ |
| 01 | — | 480030868 | RAILROAD MEDICARE | AZ |
| 01 | — | 5507194 | AETNA | AZ |
| 01 | — | 6287561009 | CIGNA | AZ |
| 01 | — | AZ0191940 | BLUE CROSS BLUE SHIELD | AZ |