Individual
BRADLEY JAY FEDDERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8100
(414) 762-4225
Mailing address
2845 GREENBRIER RD, GREEN BAY, WI 54311-6519
(920) 288-8100
(414) 762-4225
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
30118-20
WI
208M00000X
Hospitalist Physician
Primary
30118
WI
Other
Enumeration date
08/05/2006
Last updated
06/26/2019
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