Individual
BRADLEY HENNINGSGAARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2301 ERWIN RD DEPARTMENT OF RADIOLOGY, DURHAM, NC 27710-1645
(919) 684-7284
(919) 613-2680
Mailing address
5345 SILVER MOON LN, RALEIGH, NC 27606-4534
(512) 426-1814
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-06919
NC
Other
Enumeration date
10/23/2014
Last updated
02/24/2022
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