Individual
BRADLEY REX SHUMWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4447 E BROADWAY RD STE 107, MESA, AZ 85206-2018
(480) 550-9610
(480) 500-6856
Mailing address
4447 E BROADWAY RD STE 107, MESA, AZ 85206-2018
(480) 550-9610
(480) 500-6856
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
006808
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/02/2014
Last updated
01/14/2020
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