Healthcare Provider Details

I. General information

NPI: 1194744474
Provider Name (Legal Business Name): BRADLEY THOMAS OLIVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22725 HIGHWAY 76 E
CLINTON SC
29325-7527
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-833-9100
  • Fax: 864-833-9458
Mailing address:
  • Phone: 864-695-6697
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number29192
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number29192
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: