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Individual

BRADFORD ALAN TYLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 341-3300
(910) 815-2882
Mailing address
1202 MEDICAL CENTER DR, WILMINGTON, NC 28401-7307
(910) 341-3300
(910) 815-2882

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
22507
SC
208600000X
Surgery Physician
Primary
9701885
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP4697
SC
05
T67488
SC
Enumeration date
02/07/2006
Last updated
12/03/2014
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