Individual
MR. BRADLEY DORNG
Active
Individual
MR. BRADLEY DORNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.465731
IL
163W00000X
Registered Nurse
1105101-30
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
28294742A
IN
Other
Enumeration date
08/31/2023
Last updated
06/20/2025
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