Individual
BRADLEY MARK CEREMUGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
225 E WOOD ST, SPARTANBURG, SC 29303-3050
(864) 560-4420
(864) 560-5296
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
37663
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
376630
—
SC
01
—
SCM9985019
MEDICARE PIN
SC
Enumeration date
07/10/2015
Last updated
03/25/2024
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