Individual
DR. BRADLEY GRANT BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1072 N LIBERTY ST STE 203, BOISE, ID 83704-8708
(208) 302-5800
(208) 302-5855
Mailing address
3340 E GOLDSTONE DR, MERIDIAN, ID 83642-1026
(208) 302-9342
(208) 302-5180
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
101253606
VA
208000000X
Pediatrics Physician
Primary
M-12454
ID
Other
Enumeration date
06/23/2010
Last updated
02/06/2023
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