Individual
BRADLEY E WELLS
Active
Individual
BRADLEY E WELLS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
46005
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000821046
ANTHEM
KY
01
—
1427202621
VIRGINIA MEDICAID
VA
05
—
7100241640
—
KY
01
—
K091710
MEDICARE
KY
01
—
P01223063
RAILROAD MEDICARE
KY
Enumeration date
11/14/2008
Last updated
11/11/2013
Update your record
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