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General NPI Number Information
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NPI Number | 1427123793
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Entity Type | Organization
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Legal Business Name | HAVERTOWN RADIOSURGERY CENTER PC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2010 W CHESTER PIKE STE 115
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City | HAVERTOWN
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State | PA
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Zip | 19083-2700
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Country | US
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Telephone | 610-446-6850
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Fax | 610-446-6852
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Provider Business Mailing Address
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Address Line | 2010 W CHESTER PIKE STE 115
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City | HAVERTOWN
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State | PA
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Zip | 19083-2700
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Country | US
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Telephone | 610-446-6850
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Fax | 610-446-6852
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. LUTHER WELDON BRADY JR.
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Credential | MD
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Telephone | 610-446-6850
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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