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Individual

SAMUEL BRADEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3901 PINE LAKE RD STE 214, LINCOLN, NE 68516-5427
(024) 816-0004
(402) 423-4100
Mailing address
PO BOX 7239, LOVELAND, CO 80537-0239
(970) 663-2742
(970) 342-2093

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
2085R0202X
Diagnostic Radiology Physician
Primary
10117289-1205
UT
208D00000X
General Practice Physician
1234567
UT

Other

Enumeration date
11/05/2010
Last updated
06/15/2021
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