Individual
LESLIE SIRIYA BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 CAMPUS DR STE 125, SCARBOROUGH, ME 04074-7171
(207) 883-0069
Mailing address
100 CAMPUS DR UNIT 125, SCARBOROUGH, ME 04074-7171
(207) 883-0069
(207) 883-0999
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
242806
MA
207V00000X
Obstetrics & Gynecology Physician
MD21679
ME
207VX0201X
Gynecologic Oncology Physician
242806
MA
207VX0201X
Gynecologic Oncology Physician
Primary
MD21679
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110085476A
—
MA
01
—
E400422717
MEDICARE
ME
01
—
E400422720
MEDICARE
ME
Enumeration date
06/19/2006
Last updated
04/15/2025
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