Individual
DR. BRAD SUMRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A40182
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A401820
BLUE CROSS/BLUE SHIELD
CA
05
—
00A401820
—
CA
01
—
77040368493612B002
CHAMPUS
CA
Enumeration date
11/08/2005
Last updated
08/22/2007
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