Individual
BRADLEY WAYNE MONGOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 HOSPITAL DRIVE, MARTINSBURG, WV 25401
(304) 264-1000
(304) 254-1374
Mailing address
PO BOX 1150, MARTINSBURG, WV 25402-1150
(304) 264-1000
(304) 254-1374
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
21986
NV
Other
Enumeration date
10/24/2006
Last updated
03/29/2010
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