Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 37920 | AZ |
N | 207PP0204X | Pediatric Emergency Physician | 37920 | AZ |
N | 208000000X | Pediatrician | 37920 | AZ |
NPI | 1346426244 |
---|---|
Provider Name | Hans R Bradshaw |
First Address | Tucson, AZ 85711 |
Second Address | Tucson, AZ 85745-2623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2008 |
Last Update Date | 09/03/2009 |