Individual
MICHAEL J BRADBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
63 LINCOLN ST, WORCESTER, MA 01605
(508) 791-1217
(508) 831-0517
Mailing address
63 LINCOLN ST, WORCESTER, MA 01605
(508) 791-1217
(508) 831-0517
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
36753
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9745742
—
MA
01
—
M14079
BCBS OF MA
—
Enumeration date
12/06/2006
Last updated
07/08/2007
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