Individual
BRADFORD COLEGATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 CLARK ST, CAMBRIDGE, OH 43725-9232
(614) 284-0608
Mailing address
PO BOX 583, CAMBRIDGE, OH 43725-0583
(614) 284-0608
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-043797
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0472608
—
OH
Enumeration date
02/14/2006
Last updated
12/02/2011
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