Individual
DR. MICHAEL S BRADISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1850 TOWN CENTER PKWY, RESTON HOSPITAL CENTER, RESTON, VA 20190-3219
(703) 471-0919
(703) 742-9081
Mailing address
PO BOX 2757, RESTON, VA 20195-0757
(703) 471-0919
(703) 742-9081
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101237801
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010155762
—
VA
01
—
173386
ANTHEM VIGINIA
—
01
—
P00234661
RAILROAD MEDICARE
—
Enumeration date
12/19/2005
Last updated
09/30/2020
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