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Individual

BENJAMIN T. BRADLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D., PH.D.

Contact information

Practice address
15 N MEDICAL DR STE 1100, SALT LAKE CITY, UT 84112-1100
(801) 583-2787
Mailing address
15 N MEDICAL DR STE 1100, SALT LAKE CITY, UT 84112-1100
(801) 583-2787

Taxonomy

Speciality
Code
Description
License number
State
207ZM0300X
Medical Microbiology Physician
12093950-1205
UT
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
12093950-1205
UT

Other

Enumeration date
04/17/2017
Last updated
04/14/2022
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