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1609866540

NPI Code Detail

MEDICARE: BRADLEY W DICK MD

MEDICARE: BRADLEY W DICK 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	2085R0204X	Vascular & Interventional Radiology Physician	D0038425	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609866540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADLEY W DICK MD

Provider Business Mailing Address
First Line	:	PO BOX 6369
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59604-6369
Country	:	US
Telephone Number	:	406-447-2823
Fax Number	:

Provider Business Practice Location Address
First Line	:	2475 E BROADWAY ST
Second Line	:
City	:	HELENA
State	:	MT
Zip	:	59601-4928
Country	:	US
Telephone Number	:	406-457-4180
Fax Number	:

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

Provider Enumeration Date	:	10/23/2005
Last Update Date	:	03/26/2018

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Directions to “ BRADLEY W DICK MD” Practice Location

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