Physician Compare National (NPI:1093862617)

HEALTHCARE PROVIDER: ANN MARIE BRADLEY ANN BRADLEY MSW

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1093862617
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6103089115
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120531000135
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BRADLEY
	Individual professional last name
Provider First Name	ANN
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	409 PLYMOUTH RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 190
	Group Practice or individual's line 2 address
City	PLYMOUTH
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	481701493
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y