Individual
DR. SHANNON S BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3100 N 11TH ST STE 1, BISMARCK, ND 58503-1210
(701) 751-2272
Mailing address
3100 N 11TH ST STE 1, BISMARCK, ND 58503-1210
(701) 751-2272
(701) 751-0974
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
8469
ND
207VG0400X
Gynecology Physician
8469
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11308
—
ND
01
—
160051292
MEDICARE RAILROAD
ND
Enumeration date
05/20/2006
Last updated
07/01/2025
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