Individual
DR. MARK BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
593 EDDY ST, CLAVERICK 2, PROVIDENCE, RI 02903-0290
(014) 444-4000
Mailing address
125 WHIPPLE ST STE 3, PROVIDENCE, RI 02908-3258
(401) 519-0337
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
050700
CT
207P00000X
Emergency Medicine Physician
Primary
MD17161
RI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/29/2009
Last updated
10/06/2020
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