Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 01047051A | IN |
NPI | 1205844131 |
---|---|
Provider Name | Dr. Bradford Lee Bopp |
First Address | Carmel, IN 46032 |
Second Address | Carmel, IN 46032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 08/07/2007 |