Healthcare Provider Details

I. General information

NPI: 1003944406
Provider Name (Legal Business Name): BRADLEY BLEY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3920 DUPONT PKWY
TOWNSEND DE
19734-9000
US

IV. Provider business mailing address

3920 DUPONT PKWY
TOWNSEND DE
19734-9000
US

V. Phone/Fax

Practice location:
  • Phone: 302-792-7222
  • Fax: 302-792-7220
Mailing address:
  • Phone: 302-792-7222
  • Fax: 302-792-7220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC7-0003472
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License NumberC2-0008798
License Number StateDE
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberC7-0003472
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: