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Individual

DR. BRADLEY W. BAKOTIC

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2001 WESTSIDE PARKWAY, SUITE 290, ALPHARETTA, GA 30004-8514
(877) 376-7284
(770) 475-0533
Mailing address
PO BOX 6039, FALMOUTH, ME 04105-6039
(888) 302-3045
(207) 347-7401

Taxonomy

Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
048594
GA
207ZD0900X
Dermatopathology (Pathology) Physician
OS8431
FL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
OS8431
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
262219000
FL
Enumeration date
12/07/2005
Last updated
02/04/2009
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