Individual
DR. DAVID D BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
ESSENTIA HEALTH SOUTH UNIVERSITY CLINIC, 1702 UNIVERSITY DRIVE SOUTH, FARGO, ND 58103
(701) 364-3300
(701) 364-8906
Mailing address
400 E THIRD STREET MCL2CRED, DULUTH, MN 55805-1951
(218) 786-3146
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
14574
ND
208100000X
Physical Medicine & Rehabilitation Physician
52167
MN
208100000X
Physical Medicine & Rehabilitation Physician
PT14574
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
864638100
—
MN
Enumeration date
03/20/2007
Last updated
03/26/2019
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