Individual
BRAD E. MCCOLLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
8005 BAY ST STE 5, SEBASTIAN, FL 32958-3244
(772) 581-8075
(772) 581-8031
Mailing address
8005 BAY ST STE 5, SEBASTIAN, FL 32958-3244
(772) 581-8075
(772) 581-8031
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
OS9270
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
48160
BCBS FL
FL
Enumeration date
06/09/2005
Last updated
02/08/2017
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