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Individual

DR. MARK BRADSHAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
345 N RIVERVIEW ST STE 412, WICHITA, KS 67203-4202
(551) 295-8223
Mailing address
2 UNIVERSITY PLZ STE 204, HACKENSACK, NJ 07601-6211
(404) 367-3014

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
003457
GA
207R00000X
Internal Medicine Physician
0101286220
VA
207R00000X
Internal Medicine Physician
04-50270
KS
207R00000X
Internal Medicine Physician
2025052488
MO
207R00000X
Internal Medicine Physician
25IA12524000
NJ
207R00000X
Internal Medicine Physician
44688
OK
207R00000X
Internal Medicine Physician
D0102042
MD
207R00000X
Internal Medicine Physician
ME172056
FL
208M00000X
Hospitalist Physician
Primary
066574
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003112987D
GA
Enumeration date
06/11/2008
Last updated
01/26/2026
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