Provider Demographics
NPI:1922355940
Name:MCNEW, BRADLEY L (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:L
Last Name:MCNEW
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 MARBURY WAY
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63368-8573
Mailing Address - Country:US
Mailing Address - Phone:314-690-9926
Mailing Address - Fax:
Practice Address - Street 1:2363 MARBURY WAY
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63368-8573
Practice Address - Country:US
Practice Address - Phone:314-690-9926
Practice Address - Fax:314-690-9925
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2012-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20070302181835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist