Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 30765 | NE |
NPI | 1023246220 |
---|---|
Provider Name | Bradley Norman Reames |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68198-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2009 |
Last Update Date | 23/09/2018 |