MEDICARE: DON I BRADY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	0101-046930	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1043282965
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DON I BRADY MD

Provider Business Mailing Address
First Line	:	3707 BRAMBLETON AVE
Second Line	:	#2
City	:	ROANOKE
State	:	VA
Zip	:	24018-3658
Country	:	US
Telephone Number	:	540-725-7800
Fax Number	:	540-989-6752

Provider Business Practice Location Address
First Line	:	3707 BRAMBLETON AVE
Second Line	:	#2
City	:	ROANOKE
State	:	VA
Zip	:	24018-3658
Country	:	US
Telephone Number	:	540-725-7800
Fax Number	:	540-989-6752

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	07/26/2013

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Directions to “ DON I BRADY MD” Practice Location

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