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Physician Compare National (NPI:1245604768)

HEALTHCARE PROVIDER: CHRISTOPHER MICHAEL BRADSHAW PA

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

Individual Professional Information

NPI 1245604768
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 4789983578
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20160428002222
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BRADSHAW
Individual professional last name
Provider First Name CHRISTOPHER
Individual professional first name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2015
Individual professional's medical school graduation year
Primary Specialty PHYSICIAN ASSISTANT
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2034 E SOUTHERN AVE
Group Practice or individual's line 1 address
Line 2 Street Address SUITE D
Group Practice or individual's line 2 address
City TEMPE
Group Practice or individual's city
State AZ
Group Practice or individual's state
Zip Code 852827511
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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