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BEN P BRADENHAM MD

Physicians Internal Medicine Gastroenterology

Provider NPI: 1275529968

Provider Information:
 BEN P BRADENHAM MD
Gender: M
Not Sole Proprietor

Practice Location:
7611 FOREST AVE STE 410 RICHMOND, VA 23229-4946 US
Tel: 804-285-2965  Fax: 804-282-0616

Business Mailing Address:
2369 STAPLES MILL RD STE 200 RICHMOND, VA 23230-2918 US
Tel: 804-285-4465  Fax: 804-285-8332

NPI Information:
NPI: 1275529968
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207RG0100XPhysicians
Internal Medicine
Gastroenterology
VA0101029475

Other Provider Identifiers:

IssuerNumberStateType
006011420VA05



American Medical Association 2012 taxonomy code information

Code: 207RG0100X

Type:

Classification:



Definition:



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