Individual
DR. BRADLEY BLAIR BIRT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
BP1-0026278
TX
2085R0202X
Diagnostic Radiology Physician
Primary
N4299
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3851910300
MYUTMB 3851910300-COMMERCIAL NUMBER
—
Enumeration date
06/14/2007
Last updated
10/03/2016
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