Individual
DR. BRADLEY PAUL CHAMPAGNE
Active
Individual
DR. BRADLEY PAUL CHAMPAGNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
206155
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2147846
—
LA
01
—
600535AI32
MEDICARE
—
05
—
INTERN
—
LA
Enumeration date
06/10/2011
Last updated
10/18/2021
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