MEDICARE: BRUCE RYAN BRADY M.D.

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	4848635-1205	UT

General Provider Information

NPI Number	:	1467474676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE RYAN BRADY M.D.

Provider Business Mailing Address
First Line	:	PO BOX 571800
Second Line	:
City	:	MURRAY
State	:	UT
Zip	:	84157-1800
Country	:	US
Telephone Number	:	801-747-2800
Fax Number	:	801-747-3022

Provider Business Practice Location Address
First Line	:	470 EAST 3900 SOUTH
Second Line	:	#200
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-2332
Country	:	US
Telephone Number	:	801-747-2800
Fax Number	:	801-747-3022

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/21/2010

Similar Medicare Providers

1891906541 — DR. SUSAN ABU-KHALAF M.D.
Practice Location Address:

470 EAST 3900 SOUTH , #200
SALT LAKE CITY, UT
84107-2332

Practice Phone: 801-747-2800
Practice Fax: 801-747-3022

1417121609 — UTAH ENDOCRINOLOGY ASSOCIATES PLLC
Practice Location Address:

470 EAST 3900 SOUTH , #200
SALT LAKE CITY, UT
84107-2332

Practice Phone: 801-747-2800
Practice Fax: 801-747-3022

1598213175 — JACLYNN WILKERSON
Practice Location Address:

470 E 3900 S STE 200
SALT LAKE CITY, UT
84107-2332

Practice Phone: 801-747-2800
Practice Fax:

1689187627 — KELLY PERKINS PA
Practice Location Address:

470 E 3900 S STE 200
SALT LAKE CITY, UT
84107-2332

Practice Phone: 801-747-2800
Practice Fax:

1295346591 — PATRICIA MYRUP AXTMAN APRN-BC
Practice Location Address:

470 E 3900 S STE 200
SALT LAKE CITY, UT
84107-2332

Practice Phone: 801-747-2800
Practice Fax: 801-747-5222

1548904451 — LYNAE CLARK SORENSEN APRN
Practice Location Address:

470 E 3900 S STE 200
SALT LAKE CITY, UT
84107-2332

Practice Phone: 801-747-2800
Practice Fax:

Directions to “ BRUCE RYAN BRADY M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.