Individual
DR. BRADLEY C BRENTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
24637
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02898
WORK COMP
NC
01
—
14876
BCBS NC STATE
NC
05
—
8914876
—
NC
Enumeration date
04/06/2006
Last updated
11/29/2011
Update your record
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