Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | C7-0003472 | DE |
N | 111NI0900X | Internist | C7-0003472 | DE |
N | 208000000X | Pediatrician | C7-0003472 | DE |
NPI | 1003944406 |
---|---|
Provider Name | Dr. Bradley Bley |
First Address | Wilmington, DE 19808-5408 |
Second Address | Newark, DE 19713-2102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2007 |
Last Update Date | 05/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003944406 | (05) | DE |