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Organization

BRADLEY J RICHARDSON MD ED D INC

Active
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Organization

BRADLEY J RICHARDSON MD ED D INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRADLEY J RICHARDSON MD (OWNER)
(304) 529-0483
Entity
Organization

Contact information

Practice address
2828 1ST AVE, SUITE 510, HUNTINGTON, WV 25702
(304) 529-0483
(304) 781-2687
Mailing address
2828 1ST AVE, SUITE 510, HUNTINGTON, WV 25702
(304) 529-0483
(304) 781-2687

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18231
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810004242
WV
Enumeration date
05/31/2006
Last updated
03/20/2008
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