Provider Demographics
NPI:1821066788
Name:BRADSHAW, DAVID C (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:C
Last Name:BRADSHAW
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 1:280 N HOSPITAL DR STE 2
Mailing Address - Street 2:
Mailing Address - City:PRICE
Mailing Address - State:UT
Mailing Address - Zip Code:84501-4211
Mailing Address - Country:US
Mailing Address - Phone:435-613-2229
Mailing Address - Fax:435-613-2230
Practice Address - Street 1:280 N HOSPITAL DR STE 2
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4211
Practice Address - Country:US
Practice Address - Phone:435-613-2229
Practice Address - Fax:435-613-2230
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8066427-1205207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology