Individual
DR. BRADLY SCOTT SHOLLENBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
4885 DEMOSS RD, SUITE 103, READING, PA 19606-9023
(610) 779-4020
(610) 776-7044
Mailing address
4885 DEMOSS RD, SUITE 103, READING, PA 19606-9023
(610) 779-4020
(610) 776-7044
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
SC002902L
PA
213ES0103X
Foot & Ankle Surgery Podiatrist
SC002902L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020421000
KHPE
PA
05
—
011820330007
—
PA
01
—
01328801
BLUE CROSS
PA
01
—
0522660000
KHPE
PA
01
—
116509
MED PLUS
PA
01
—
31854
MERCY
PA
01
—
688055
BLUE SHIELD
PA
01
—
7990970
GATEWAY
PA
Enumeration date
11/05/2005
Last updated
11/02/2007
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