Individual
DR. LISA ANN WHITTY BRADLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7905 CALUMET AVE, MUNSTER, IN 46321-2549
(219) 836-7506
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
01079522B
IN
208600000X
Surgery Physician
01079522A
IN
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
01079522A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0361102441
—
IL
01
—
7215166
BCBS
IL
Enumeration date
08/12/2006
Last updated
03/16/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us