Individual
SAMUEL BRADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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