Organization
STATESVILLE CARDIOVASCULAR CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES HEDRICK BRADFORD MD (PRESIDENT)
(704) 873-1180
Entity
Organization
Contact information
Practice address
738 BRYANT ST, SUITE A, STATESVILLE, NC 28677-4189
(704) 873-1180
(704) 873-1116
Mailing address
738 BRYANT ST, SUITE A, STATESVILLE, NC 28677-4189
(704) 873-1180
(704) 873-1116
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0265T
BCBS
NC
01
—
250919
MAMSI
NC
05
—
890265T
—
NC
01
—
CD2252
PALMETTO GBA RR MEDICARE
NC
Enumeration date
08/20/2006
Last updated
08/13/2007
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