Individual
BRADLEY PAUL EVERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 INDIAN WOOD CIR STE 202B, MAUMEE, OH 43537
(419) 578-8594
(855) 618-2622
Mailing address
1900 INDIAN WOOD CIR STE 202B, MAUMEE, OH 43537-4039
(419) 578-8594
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-097443
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0050614
—
OH
01
—
1841239274
PARTNERS PHYSICIAN GROUP TYPE 2 NPI #
OH
01
—
2551671
PARTNERS PHYSICIAN GROUP MEDICAID #
OH
01
—
9338635
PARTNERS PHYSICIAN GROUP MEDICARE #
OH
Enumeration date
09/29/2008
Last updated
06/15/2022
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