Individual
BRADLEY WEAVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD/PHD
Contact information
Practice address
30 N MEDICAL DR, SALT LAKE CITY, UT 84132-3228
(801) 608-2723
Mailing address
30 N MARIO CAPECCHI RM 2S100, SALT LAKE CITY, UT 84112
(801) 581-7553
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
14241132-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/15/2022
Last updated
11/21/2025
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