MEDICARE: DR. ANDREW BRADFORD PHD

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	246ZB0500X	Biochemist

General Provider Information

NPI Number	:	1649967696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW BRADFORD PHD

Provider Business Mailing Address
First Line	:	MS 8613, P15-3007
Second Line	:	12700 E 19TH AVE
City	:	AURORA
State	:	CO
Zip	:	80045
Country	:	US
Telephone Number	:	303-724-3507
Fax Number	:

Provider Business Practice Location Address
First Line	:	MS 8613, P15-3007
Second Line	:	12700 E 19TH AVE
City	:	AURORA
State	:	CO
Zip	:	80045
Country	:	US
Telephone Number	:	303-724-3507
Fax Number	:

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

Provider Enumeration Date	:	04/20/2023
Last Update Date	:	04/20/2023

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