MEDICARE: DR. HENRY CHASE BRADFORD IV 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	2084P0800X	Psychiatry Physician	156562	FL

General Provider Information

NPI Number	:	1245791656
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY CHASE BRADFORD IV MD

Provider Business Mailing Address
First Line	:	8229 NEW CUT RD
Second Line	:
City	:	CAMPOBELLO
State	:	SC
Zip	:	29322-8733
Country	:	US
Telephone Number	:	508-985-8805
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 THE PKWY STE L
Second Line	:
City	:	GREER
State	:	SC
Zip	:	29650-5205
Country	:	US
Telephone Number	:	508-985-8805
Fax Number	:

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

Provider Enumeration Date	:	03/28/2019
Last Update Date	:	04/07/2026

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