Provider Demographics
NPI:1376925115
Name:NAVIA, BRADFORD
Entity Type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:
Last Name:NAVIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TWIN POND LN
Mailing Address - Street 2:
Mailing Address - City:SUDBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01776-1132
Mailing Address - Country:US
Mailing Address - Phone:978-443-1966
Mailing Address - Fax:
Practice Address - Street 1:14 TWIN POND LN
Practice Address - Street 2:
Practice Address - City:SUDBURY
Practice Address - State:MA
Practice Address - Zip Code:01776-1132
Practice Address - Country:US
Practice Address - Phone:978-443-1966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-28
Last Update Date:2015-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA56112207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine