Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 28295 | WV |
N | 207PE0004X | Emergency Medical Services | 28295 | WV |
NPI | 1154703536 |
---|---|
Provider Name | Dr. Bradley Matthew End |
First Address | Morgantown, WV 26506-1200 |
Second Address | Morgantown, WV 26506 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2015 |
Last Update Date | 12/01/2021 |