Individual
EARL B BRADLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1503 HIGHWAY ONE, LEWES, DE 19958-9641
(302) 645-0222
(302) 645-0899
Mailing address
1503 HIGHWAY ONE, LEWES, DE 19958-9641
(302) 645-0222
(302) 645-0899
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C1-1004285
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001097002
DELAWARE PHYSICIANS CARE
DE
05
—
0001097002
—
DE
01
—
0895293000
AMERIHEALTH
DE
01
—
883092
MAMSI
DE
01
—
E96011
BCBS DE
DE
Enumeration date
06/12/2006
Last updated
07/09/2007
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