Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | OS012456 | PA |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | OS012456 | PA |
NPI | 1235207077 |
---|---|
Provider Name | Dr. Bradley A. Barter |
First Address | State College, PA 16801-7965 |
Second Address | State College, PA 16801-7965 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 29/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01948723 | (05) | PA |
H59109 | (02) | PA |