Individual
MR. ROBERT BRADLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
405 GRAND AVE, DAYTON, OH 45405-4720
(937) 723-3200
(937) 723-5109
Mailing address
PO BOX 711131, CINCINNATI, OH 45271-1131
(937) 293-0247
(937) 293-0969
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN132183
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000003646
ANTHEM
OH
05
—
2042471
—
OH
Enumeration date
09/13/2006
Last updated
07/08/2007
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