Individual
BRADLEY S. PERSINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
80 ROCKCREST DR, SOUTH CHARLESTON, WV 25309-2327
(304) 542-3927
(304) 768-2468
Mailing address
80 ROCKCREST DR, SOUTH CHARLESTON, WV 25309-2327
(304) 542-3927
(304) 768-2468
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
48580
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2604261000
—
WV
01
—
27-3419445
TAX ID
WV
Enumeration date
08/31/2006
Last updated
04/21/2011
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