Individual
DR. VELMA SUSAN BRADFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
8610 W OVERLAND RD, BOISE, ID 83709-1645
(208) 954-8711
(208) 375-2217
Mailing address
777 N RAYMOND ST, BOISE, ID 83704-9251
(208) 514-2500
(208) 375-2217
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
M7541
ID
208000000X
Pediatrics Physician
Primary
M-7541
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629070636
—
ID
05
—
805219300
—
ID
Enumeration date
08/10/2005
Last updated
12/15/2023
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