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Individual
DR. BRADLEY KING
Active
Individual
DR. BRADLEY KING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3734
WV
208M00000X
Hospitalist Physician
3734
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000061
—
OH
01
—
004995730
HIGHMARK
WV
05
—
1881150035
—
WV
05
—
7100840490
—
KY
01
—
WVD438A
MEDICARE
WV
Enumeration date
02/13/2019
Last updated
10/25/2022
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