Individual
DR. KEVIN C. BRADSHAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
519 PEABODY ST NE, WASHINGTON, DC 20011-1647
(202) 285-1465
(202) 635-2305
Mailing address
519 PEABODY ST NE, WASHINGTON, DC 20011-1647
(202) 285-1465
(202) 635-2305
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO526
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0115995 00
—
DC
01
—
48002901
MEDICARE/RAILROAD PIN
—
Enumeration date
12/11/2006
Last updated
11/10/2008
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