Individual
JOHN DAVID BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-8426
(336) 716-2255
Mailing address
10140 CENTURION PKWY N, JACKSONVILLE, FL 32256-0532
(904) 697-4127
(904) 697-5102
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2019-02392
NC
207LP3000X
Pediatric Anesthesiology Physician
ME129022
FL
390200000X
Student in an Organized Health Care Education/Training Program
18347
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024846300
—
FL
Enumeration date
05/09/2013
Last updated
10/28/2019
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