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Individual

BRADLEY RANDALL SELLERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
33 NORTH AVE, SUITE 103, TALLMADGE, OH 44278-1925
(330) 633-3883
(330) 633-6658
Mailing address
1320 CORPORATE DR, STE 200, HUDSON, OH 44236-4442
(330) 633-3883
(330) 253-8629

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-08-1663-S
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000181144
THREE RIVERS HEALTH PLANS
01
000000341614
ANTHEM BCBS
05
2345877
OH
01
729962
BUCKEYE COMMUNITY HEALTH
01
796
SUMMACARE HEALTH PLAN
01
Q039874
HOMETOWN HEALTH NETWORK
Enumeration date
02/21/2006
Last updated
03/03/2022
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