NPI 1023289964 · live from the CMS NPI Registry
Bradley William Gardner, O.D.
Optometrist in Wilmington, DE. National Provider Identifier 1023289964, active.
NPI record
| NPI | 1023289964 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 5301 Limestone Rd, Suite 128, Wilmington, DE 19808 |
| Practice phone | 302-239-1933 |
| Enumerated | March 19, 2008 |
| Last updated | May 11, 2012 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | I3-0001325 (DE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.