Individual
BRADLEY NINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1297
(304) 388-5432
Mailing address
3200 MACCORKLE AVE SE, CHARLESTON, WV 25304-1297
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
15916
WV
207R00000X
Internal Medicine Physician
Primary
15916
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00683538
BLUE CROSS BLUE SHIELD
WV
05
—
0075463000
—
WV
05
—
0891003
—
OH
01
—
3001160
WORKERS COMPENSATION
WV
05
—
64699267
—
KY
Enumeration date
05/17/2006
Last updated
10/13/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us