Individual
PATRICIA ANN BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
222 SOUTHWAY AVE, STE C, LEWISTON, ID 83501-2703
(208) 746-1333
(208) 746-8090
Mailing address
222 SOUTHWAY AVE, STE C, LEWISTON, ID 83501-2703
(208) 746-1333
(208) 746-8090
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M4526
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002615300
—
ID
Enumeration date
01/27/2006
Last updated
10/16/2008
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