Provider Demographics
NPI:1609042779
Name:BRADY-THOMAS, SUNSHINE CATHLEEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:SUNSHINE
Middle Name:CATHLEEN
Last Name:BRADY-THOMAS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 FALCON DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-1930
Mailing Address - Country:US
Mailing Address - Phone:540-371-2724
Mailing Address - Fax:540-371-5072
Practice Address - Street 1:195 FALCON DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-1930
Practice Address - Country:US
Practice Address - Phone:540-371-2724
Practice Address - Fax:540-371-5072
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO60013358213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8519845Medicaid
WAG8874599Medicare PIN