Individual
DR. LOUISE BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4024A OLD TAR RD, WINTERVILLE, NC 28590-8430
(252) 355-3773
(252) 355-1958
Mailing address
4024A OLD TAR RD, WINTERVILLE, NC 28590-8430
(252) 355-3773
(252) 355-1958
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
00-32643
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17653
BCBS NC
NC
05
—
8917653
—
NC
01
—
P00042858
RR MEDICARE
NC
Enumeration date
06/29/2006
Last updated
04/21/2010
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