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DR. ELOISE DANIEL BRADHAM M.D

>> Specialist >> Other Service Providers

Registrant NPI Number: 1194767905

Individual Registrant:
DR. ELOISE DANIEL BRADHAM M.D
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3109 ION AVE  SULLIVANS ISLAND, SC 29482-8606 US
Tel: 843-870-7518  Fax: --

Contact information for business:
PO BOX 126  SULLIVANS ISLAND, SC 29482-0126 US
Tel: 843-870-7518  Fax: --

Registration Information:
NPI: 1194767905
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N174400000XOther Service Providers
Specialist
SC13644
Y207L00000XAllopathic & Osteopathic Physicians
Anesthesiology
SC13644

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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