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General NPI Number Information
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NPI Number | 1770659229
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Entity Type | Individual
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Provider Name | BRADLEY PAUL STOLTZ PHARMD., RPH.
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 101 CORPORATE BLVD STE 108
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City | WEST COLUMBIA
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State | SC
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Zip | 29169-4665
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Country | US
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Telephone | 803-794-5950
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Fax |
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Provider Business Mailing Address
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Address Line | 6 BELFAIR CT
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City | IRMO
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State | SC
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Zip | 29063-8263
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Country | US
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Telephone | 803-542-7343
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Fax |
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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 | 1835N0905X
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Taxonomy Name | Nuclear Pharmacist
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License Number | 16105
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License Number State | CO
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