Individual
BRADLEY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
13 INDUSTRIAL PARK RD, SACO, ME 04072-1804
(207) 283-8800
(207) 286-9853
Mailing address
P.O. BOX 626, BIDDEFORD, ME 04005-0626
(207) 282-9080
(207) 286-9853
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA249
ME
363A00000X
Physician Assistant
Primary
PA-249
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245465038
—
ME
Enumeration date
05/21/2009
Last updated
04/01/2019
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