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General NPI Number Information
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NPI Number | 1366433591
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Entity Type | Individual
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Provider Name | BRADLY SCOTT SHOLLENBERGER D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 11/05/2005
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 4885 DEMOSS RD SUITE 103
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City | READING
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State | PA
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Zip | 19606-9023
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Country | US
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Telephone | 610-779-4020
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Fax | 610-776-7044
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Provider Business Mailing Address
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Address Line | 4885 DEMOSS RD SUITE 103
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City | READING
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State | PA
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Zip | 19606-9023
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Country | US
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Telephone | 610-779-4020
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Fax | 610-776-7044
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | SC002902L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC002902L
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License Number State | PA
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