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General NPI Number Information
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NPI Number | 1851350326
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Entity Type | Individual
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Provider Name | DANIEL WILLIAM BRADFORD MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 03/22/2006
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Last Update Date | 08/08/2022
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Provider Practice Location Address
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Address Line | 508 FULTON ST DURHAM VAMC
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City | DURHAM
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State | NC
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Zip | 27705-3875
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Country | US
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Telephone | 919-286-0411
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Fax | 919-869-1343
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Provider Business Mailing Address
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Address Line | 508 FULTON ST DURHAM VAMC
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City | DURHAM
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State | NC
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Zip | 27705-3875
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Country | US
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Telephone | 919-286-0411
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Fax | 919-869-1343
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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 | 2084A0401X
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Taxonomy Name | Addiction Medicine (Psychiatry & Neurology) Physician
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License Number | 0101264177
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 200100312
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101264177
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License Number State | VA
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