Individual
BRADLEY ALAN TAIT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
USA MEDDAC, 11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY 13602-0000
(315) 772-2778
Mailing address
USA MEDDAC, 11050 MOUNT BELVEDERE BLVD, FORT DRUM, NY 13602-0000
(315) 772-2778
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
10772
GA
207P00000X
Emergency Medicine Physician
317171
NY
Other
Enumeration date
04/14/2019
Last updated
08/01/2022
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