MEDICARE: CRISTER BRADY 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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	2021-02461	NC

General Provider Information

NPI Number	:	1780057869
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRISTER BRADY MD

Provider Business Mailing Address
First Line	:	100 VILLAGE CENTER DR STE 1002
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-7189
Country	:	US
Telephone Number	:	984-215-6550
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 VILLAGE CENTER DR STE 1002
Second Line	:
City	:	CHAPEL HILL
State	:	NC
Zip	:	27516-7189
Country	:	US
Telephone Number	:	984-215-6550
Fax Number	:

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

Provider Enumeration Date	:	11/11/2015
Last Update Date	:	09/23/2025

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Directions to “ CRISTER BRADY MD” Practice Location

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