Individual
BRADLEY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
420 DELAWARE ST SE, MMC 404 UNIVERSITY OF MINNESOTA, MINNEAPOLIS, MN 55455
(612) 624-5409
(612) 626-5262
Mailing address
420 DELAWARE ST SE, MMC 404 UNIVERSITY OF MINNESOTA, MINNEAPOLIS, MN 55455
(612) 624-5409
(612) 626-5262
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
41017
MN
2080P0205X
Pediatric Endocrinology Physician
Primary
41017
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006136
—
MT
05
—
006136
—
WI
01
—
126279
UCARE
—
01
—
33-00031
MEDICA PRIMARY
—
01
—
33-00127
MEDICA CHOICE/SELECT CARE
—
01
—
548A4MI
BCBS-MN
MN
01
—
930078007
MN RR
MN
01
—
96198101860
PREFERRED ONE
—
01
—
HP27040
HEALTHPARTNERS
—
01
—
PHCS
929357
—
Enumeration date
08/07/2006
Last updated
04/23/2015
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