Individual
BRADLEY MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 PIEDMONT AVE, CINCINNATI, OH 45219-4231
(513) 475-7880
(513) 475-8766
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5507
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35071701M
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64962608
—
KY
Enumeration date
04/12/2006
Last updated
03/21/2019
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