Doctor Name: | BRADLEY A BLACKBURN |
NPI Number: | 1033102124 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 35053437 |
Business Practice Address: | 103 Partridge Ln Chagrin Falls, OH - 440224010 |
Business Phone Number: | 4402473258 |
Business Fax Number: | 4402477459 |
Mailing Address: | 103 Partridge Ln, CHAGRIN FALLS |
State: | OH |
Postal Code: | 440224010 |
Phone Number: | 4402473258 |
Fax Number: | 4402477459 |
NPI Enumeration Date: | 08/24/2005 |
NPI Last Update Date: | 03/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085R0202X |
License Number: | 35053437 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Diagnostic Radiology |
Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |