Doctor Name: | DR. STEPHEN P BRADLEY |
NPI Number: | 1295825651 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | MD-6995 |
Business Practice Address: | 86-260 Farrington Hwy Waianae, HI - 967923128 |
Business Phone Number: | 8086973300 |
Business Fax Number: | 8086973687 |
Mailing Address: | 86-260 Farrington Hwy, WAIANAE |
State: | HI |
Postal Code: | 967923128 |
Phone Number: | 8086973300 |
Fax Number: | 8086973687 |
NPI Enumeration Date: | 10/13/2006 |
NPI Last Update Date: | 09/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD-6995 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |