Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | MD432317 | PA |
NPI | 1124057021 |
---|---|
Provider Name | Dr. Angela R Bradbury |
First Address | Philadelphia, PA 19104-4204 |
Second Address | Philadelphia, PA 19104-4204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2006 |
Last Update Date | 30/05/2012 |