Provider Demographics
NPI:1285673582
Name:BRADY, JOANNA M (MD)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:M
Last Name:BRADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:2 KEEFER DR
Practice Address - Street 2:
Practice Address - City:MERCERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17236-1732
Practice Address - Country:US
Practice Address - Phone:717-328-2119
Practice Address - Fax:717-328-0071
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD069405L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA120420417OtherDEPT OF LABOR
PA23-1401561OtherMULTIPLAN/PHCS
PA23-1401561OtherHEALTHNET/TRICARE
PA6367958OtherAETNA HMO
DCV007-0006OtherCAREFIRST DC
PA1285673582OtherHEALTH AMERICA
PA1568815OtherGATEWAY GROUP
PA23-1401561OtherSOUTH CENTRAL PREFERRED
PA23-1401561OtherDEVON
MD901151-02OtherCAREFIRST MD
PA001799285002Medicaid
PAMD069405LOtherPHYSICIAN LICENSE
PA1007307260034OtherMEDICAID GROUP #
10923537OtherCAQH
PA23-1401561OtherFIRST HEALTH
PA23-1401561OtherINTERGROUP
PA001799285 0006Medicaid
PA7453150OtherAETNA NON-HMO
PABR181837OtherHIGHMARK BLUESHIELD
PAP010548OtherGATEWAY
V007/D0MZMOOtherCAREFIRST GROUP
PA23-1401561OtherGREATWEST HEALTHCARE
PA867633OtherMEDICARE GROUP #
PA23-1401561OtherINFORMED
PA305587OtherUNISON
PA50093786OtherCAPITAL BLUECROSS
PAP00841811OtherRAILROAD MEDICARE
PAP010548OtherGATEWAY
PA001799285002Medicaid