Individual
KEVIN BRADLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3133
(215) 717-3945
Mailing address
3425 N CARLISLE ST, 2ND FLOOR HUDSON BLDG, PHILADELPHIA, PA 19140-5108
(215) 707-4739
(215) 707-3677
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD067035L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00177725680006
—
PA
Enumeration date
10/13/2005
Last updated
07/08/2007
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