Individual
ROBERT DANA BRADSHAW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
825 FAIRFAX AVE, HOFHEIMER HALL, SUITE 118, NORFOLK, VA 23507-1914
(757) 446-5955
(757) 446-5196
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-5955
(757) 446-5196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101244161
VA
2083P0901X
Public Health & General Preventive Medicine Physician
0101244161
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-002
TRICARE/CHAMPUS
VA
01
—
-003
TRICARE/CHAMPUS
VA
01
—
10086236
OPTIMA HEALTH
VA
01
—
19827411872
VIRGINIA PREMIER HEALTH PLAN
VA
01
—
1982741872
UNITED HEALTHCARE
VA
05
—
1982741872
—
NC
05
—
1982741872
—
VA
01
—
455290
ANTHEM BC/BS
VA
01
—
PAR
VIRGINIA HEALTH NETWORK
VA
Enumeration date
01/31/2007
Last updated
01/30/2015
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