Organization
JOHN W. BRADY, JR., M.D. PLLC
Active
Parent organization
JOHN W. BRADY, JR. M.D. PLLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
JOHN W. BRADY, JR. M.D. PLLC
Authorized official
DR. JOHN WILLIAM BRADY JR. MD (OWNER)
(703) 369-3376
Entity
Organization
Contact information
Practice address
8650 SUDLEY ROAD, SUITE 310, MANASSAS, VA 20110-4416
(703) 369-3376
(703) 369-1118
Mailing address
8650 SUDLEY ROAD, SUITE 310, MANASSAS, VA 20110-4416
(703) 369-3376
(703) 369-1118
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101019666
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C10547
PTAN
—
Enumeration date
06/09/2008
Last updated
10/29/2008
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