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BRADLEY ERIC JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
800 SPRUCE ST, PHILADELPHIA, PA 19107-6130
(215) 829-5410
Mailing address
151 FRIES MILL RD STE 301, TURNERSVILLE, NJ 08012-2016
(856) 513-4124

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OT014800
PA
208M00000X
Hospitalist Physician
Primary
25MB09666100
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0534650
NJ
Enumeration date
05/17/2012
Last updated
02/06/2020
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