NPI 1194767905 · live from the CMS NPI Registry
Eloise Daniel Bradham, M.D
Anesthesiology in Sullivans Island, SC. National Provider Identifier 1194767905, active.
NPI record
| NPI | 1194767905 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Anesthesiology 207L00000X |
| Practice location | 3109 Ion Ave, Sullivans Island, SC 29482 |
| Practice phone | 843-870-7518 |
| Mailing address | Po Box 126, Sullivans Island, SC 29482 |
| Enumerated | June 13, 2006 |
| Last updated | September 16, 2015 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist | 174400000X | 13644 (SC) |
| Anesthesiology primary | 207L00000X | 13644 (SC) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.