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Individual

DR. STEPHEN K BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1795 S DEVONSHIRE DR, SALT LAKE CITY, UT 84108-2562
(801) 860-5905
(855) 242-1691
Mailing address
1795 S DEVONSHIRE DR, SALT LAKE CITY, UT 84108-2562
(801) 860-5905
(855) 242-1691

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
172488-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002086464
NV
05
103500200
WY
01
107006512102
IHC
UT
01
1502954
UMWA
UT
01
17839
DESERET MUTUAL
UT
01
2090168
UNITED HEALTHCARE
UT
01
44140
HEALTHY U
UT
01
73544
PEHP
UT
05
806727300
ID
05
820771
AZ
01
870545614SB3
EDUCATORS MUTUAL
UT
01
PRA07396
MOLINA
UT
01
QM0000075886
ALTIUS
UT
Enumeration date
10/03/2006
Last updated
04/21/2021
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