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Individual

DR. JOHN GREG BRADY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
798 HAUSMAN RD, SUITE 310, ALLENTOWN, PA 18104-9108
(610) 432-0200
(610) 432-0202
Mailing address
798 HAUSMAN RD, SUITE 310, ALLENTOWN, PA 18104-9108
(610) 432-0200
(610) 432-0202

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
OS004677L
PA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
OS004677L
PA
207NS0135X
Procedural Dermatology Physician
OS004677L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
50094289
CAPITAL BC
PA
01
735359
HIGHMARK BS
PA
Enumeration date
10/04/2005
Last updated
01/22/2015
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