Individual
BRADLEY CHARLES BANDERA
Active
Individual
BRADLEY CHARLES BANDERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
61600
GA
2086X0206X
Surgical Oncology Physician
Primary
A135798
CA
390200000X
Student in an Organized Health Care Education/Training Program
61600
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427205681
—
MO
05
—
200619660A
—
OK
05
—
201124040A
—
KS
Enumeration date
08/19/2008
Last updated
11/29/2018
Update your record
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