Individual
DR. BRADLEY D. WIEKRYKAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140
(484) 269-4523
Mailing address
919 CORINTHIAN AVE APT 8, PHILADELPHIA, PA 19130-1465
(267) 780-3720
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD472172
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
MT215125
—
PA
Enumeration date
06/08/2018
Last updated
08/13/2024
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