Individual
BRADLEY WILLIAM NICHOLSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18877 JEB STUART HWY, STUART, VA 24171
(276) 694-4466
(276) 694-2909
Mailing address
PO BOX 1019, STUART, VA 24171-1019
(276) 694-4466
(276) 694-2909
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0101030962
VA
Other
Enumeration date
07/07/2005
Last updated
07/08/2007
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