Provider Demographics
NPI:1639708522
Name:CLEMENS, BRADLEY HOBART (DO)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:HOBART
Last Name:CLEMENS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 GREENBRIER CIR STE A
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23320-3338
Mailing Address - Country:US
Mailing Address - Phone:757-461-3400
Mailing Address - Fax:757-461-7130
Practice Address - Street 1:816 GREENBRIER CIR STE A
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23320-3338
Practice Address - Country:US
Practice Address - Phone:757-461-3400
Practice Address - Fax:757-461-7130
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5151014362207R00000X
390200000X
VA0116037531390200000X
VA0102209328207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program