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Individual

BRADY C WAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
210 PENNY LN, MOREHEAD CITY, NC 28557-4305
(252) 247-4769
(252) 247-0948
Mailing address
3325 PIEDMONT RD NE, BLDG 7-601, ATLANTA, GA 30305-1889
(404) 842-5600
(404) 848-8611

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
20985
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020017133
RAILROAD MEDICARE NUMBER
01
86054
NC BCBS NUMBER
NC
05
8986054
NC
Enumeration date
06/13/2006
Last updated
03/16/2010
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