Individual
DR. BRADFORD T ALLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3800 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3212
Mailing address
3800 PARK NICOLLET BLVD, CREDENTIALING, ST LOUIS PARK, MN 55416-2527
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
26361
MN
2085R0202X
Diagnostic Radiology Physician
Primary
26361
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891080400
—
MN
Enumeration date
12/23/2005
Last updated
02/29/2012
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