Individual
MR. BRADLEY HUSTON WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
125 COMMONWEALTH DR, GREENVILLE, SC 29615-4812
(864) 675-4511
Mailing address
503 SPAULDING LAKE DR, GREENVILLE, SC 29615-6036
(864) 915-1105
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN 240
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0940
—
SC
Enumeration date
02/20/2007
Last updated
07/08/2007
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