Doctor Name: | BRADLEY R DYER |
NPI Number: | 1023214509 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 5325 Faraon St Ms 1020 Division Of General And Geriatric Medicine Univ Saint Joseph, MO - 645063488 |
Business Phone Number: | 8162716406 |
Business Fax Number: | |
Mailing Address: | 5325 Faraon St, Ms 4017 Kansas University Physicians, Inc. SAINT JOSEPH |
State: | MO |
Postal Code: | 645063488 |
Phone Number: | 8162716406 |
Fax Number: | |
NPI Enumeration Date: | 06/22/2007 |
NPI Last Update Date: | 07/08/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | KS |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |