MEDICARE: DR. BRADLEY MICHAEL MCCRADY D.O.

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	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	2557	WV
2	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician	0102202775	VA

General Provider Information

NPI Number	:	1417123118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRADLEY MICHAEL MCCRADY D.O.

Provider Business Mailing Address
First Line	:	213 S JEFFERSON ST STE 1006
Second Line	:
City	:	ROANOKE
State	:	VA
Zip	:	24011-1713
Country	:	US
Telephone Number	:	540-224-5516
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 LAMB CIR STE 380
Second Line	:
City	:	CHRISTIANSBURG
State	:	VA
Zip	:	24073-6345
Country	:	US
Telephone Number	:	540-510-6200
Fax Number	:	540-857-5306

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

Provider Enumeration Date	:	05/02/2008
Last Update Date	:	05/19/2026

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