Individual
TODD M. BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 MEMORIAL DR STE 1200, BERLIN, WI 54923-1243
(920) 361-5770
(920) 361-5779
Mailing address
225 MEMORIAL DR STE 1200, BERLIN, WI 54923-1243
(920) 361-5770
(920) 361-5779
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36541-020
WI
208600000X
Surgery Physician
36541-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32152000
—
WI
Enumeration date
08/02/2005
Last updated
10/24/2014
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