Individual
DR. BRADLEY JAMES SHUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
549 E COUNTY LINE RD, SUITE G, GREENWOOD, IN 46143-1067
(317) 881-9364
(317) 883-0881
Mailing address
549 E COUNTY LINE RD, SUITE G, GREENWOOD, IN 46143-1067
(317) 881-9364
(317) 883-0881
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009045A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100131310A
—
IN
Enumeration date
08/30/2006
Last updated
02/25/2015
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