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NPI Code Detail

MEDICARE: MICHAEL THOMAS BRADY MD

MEDICARE: MICHAEL THOMAS 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
12080P0208XPediatric Infectious Diseases Physician35046097OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
164789225OTHERKYMIS.
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30105235000OTHERWVMIS.

General Provider Information

NPI Number : 1184620361
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL THOMAS BRADY MD
Provider Business Mailing Address
First Line : 555 S 18TH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43205-2654
Country : US
Telephone Number : 614-722-4451
Fax Number : 614-722-4565
Provider Business Practice Location Address
First Line : 555 S 18TH ST
Second Line :
City : COLUMBUS
State : OH
Zip : 43205-2654
Country : US
Telephone Number : 614-722-4451
Fax Number : 614-722-4565
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 09/09/2008

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Directions to “ MICHAEL THOMAS BRADY MD” Practice Location

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