Individual
SCOTT BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5335 DISCOVERY PARK BLVD STE B, WILLIAMSBURG, VA 23188-2696
(757) 253-0603
(757) 585-7645
Mailing address
730 THIMBLE SHOALS BLVD, SUITE 130, NEWPORT NEWS, VA 23606-4562
(757) 873-1554
(757) 873-3239
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
101261721
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1548571771
UNITED HEALTHCARE
VA
05
—
1548571771
—
VA
01
—
4194090
AETNA
VA
Enumeration date
06/22/2010
Last updated
04/15/2021
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