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General NPI Number Information
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NPI Number | 1275053860
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Entity Type | Individual
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Provider Name | BRADLEY STEPHEN KVAMME MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 08/01/2022
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Provider Practice Location Address
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Address Line | 200 HAWKINS DR
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-467-2868
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Fax | 319-384-8114
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Provider Business Mailing Address
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Address Line | 200 HAWKINS DR
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-356-3444
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Fax | 319-384-8114
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | MD-49156
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License Number State | IA
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