Healthcare Provider Details

I. General information

NPI: 1649224338
Provider Name (Legal Business Name): WILLIAM L BRADLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E MURPHY AVENUE
CONNELLSVILLE PA
15425
US

IV. Provider business mailing address

7 PARKWAY CENTER SUITE 375
PITTSBURGH PA
15220
US

V. Phone/Fax

Practice location:
  • Phone: 724-626-2434
  • Fax: 724-626-2334
Mailing address:
  • Phone: 412-937-5700
  • Fax: 412-937-5739

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License NumberMD032797E
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD032797E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: