Provider Demographics
NPI:1043471659
Name:BRADSTREET, CHESTER UPTON (MD)
Entity Type:Individual
Prefix:
First Name:CHESTER
Middle Name:UPTON
Last Name:BRADSTREET
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2840 DEBARR ROAD STE 771
Mailing Address - Street 2:THE ALASKA HOSPITALIST GROUP
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508
Mailing Address - Country:US
Mailing Address - Phone:801-699-0415
Mailing Address - Fax:907-264-1951
Practice Address - Street 1:2840 DEBARR ROAD STE 771
Practice Address - Street 2:THE ALASKA HOSPITALIST GROUP
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508
Practice Address - Country:US
Practice Address - Phone:801-699-0415
Practice Address - Fax:907-264-1951
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2011-08-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK4817207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine