Individual
BRADEN LEE ALLRED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2800 BLUE RIDGE RD STE 300, RALEIGH, NC 27607-6476
(919) 784-7874
Mailing address
2800 BLUE RIDGE RD STE 300, RALEIGH, NC 27607-6476
(919) 784-7874
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08108
NC
363AS0400X
Surgical Physician Assistant
0010-08108
NC
Other
Enumeration date
07/08/2018
Last updated
08/24/2021
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