Healthcare Provider Details

I. General information

NPI: 1245290089
Provider Name (Legal Business Name): BRADLEY D HUHTA MD FACC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 N MESA AVE
MONTROSE CO
81401-3902
US

IV. Provider business mailing address

17 N MESA AVE
MONTROSE CO
81401-3902
US

V. Phone/Fax

Practice location:
  • Phone: 970-252-1020
  • Fax: 970-252-1041
Mailing address:
  • Phone: 970-252-1020
  • Fax: 970-252-1041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number35336
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number35336
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: