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NPI Code Detail

MEDICARE: DR. ANGELA R BRADBURY MD

MEDICARE: DR. ANGELA R BRADBURY 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
1207RX0202XMedical Oncology PhysicianMD432317PA

General Provider Information

NPI Number : 1124057021
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANGELA R BRADBURY MD
Provider Business Mailing Address
First Line : 3400 CIVIC CENTER BOULEVARD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4204
Country : US
Telephone Number : 215-615-5858
Fax Number : 215-349-8144
Provider Business Practice Location Address
First Line : 3400 CIVIC CENTER BOULEVARD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-4204
Country : US
Telephone Number : 215-615-5858
Fax Number : 215-349-8144
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2006
Last Update Date : 05/30/2012

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