B C Stufflebam, Md, Llc

NPI 1043453707 - Radiology - 2085R0202X

NPI Details
NPI 1043453707
Enumeration Date 04/10/2009
Last Updated 04/10/2009
Entity Type Healthcare Provider
Active Over 7 years ago
Authorized Information
Name BRADLEY CHRISTIAN BRADLEY
Position MANAGER
Phone (618) 533-0727
Fax (618) 533-1464
Practice Location
629 SABLE DR
CENTRALIA IL, 62801-4472, US
Phone (618) 533-0727
Fax (618) 533-1464
Business Location
629 SABLE DR
CENTRALIA IL, 62801-4472, US
Phone (618) 533-0727
Fax (618) 533-1464
Toxanomy
Taxonomy Code 2085R0202X
License State Illinois
License Number 036058847
Remove 1043453707 NPI Number
 

According to our database, B C Stufflebam, Md, Llc NPI is 1043453707, taxonomy code is 2085R0202X and license number is 036058847, license state is located at Illinois. B C Stufflebam, Md, Llc physically located at 629 Sable Dr, Centralia IL, 62801-4472. NPI Number 1033115704 has the healthcare provider type.

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1043453707 NPI number is provided on an as is basis without warranty of any kind. 1043453707 is maintained by the National Plan & Provider Enumeration System. The contents of B C Stufflebam, Md, Llc are for informational purposes only.