Individual
DR. MARK D. BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 632-2230
(913) 632-2297
Mailing address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2679
(913) 789-3191
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
04-24346
KS
207L00000X
Anesthesiology Physician
2000147641
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100153150D
—
KS
05
—
203948310
—
MO
01
—
50066370
RR MEDICARE
KS
Enumeration date
02/27/2006
Last updated
11/10/2020
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