Provider Demographics
NPI:1942410519
Name:BRADSHAW, HUNTER PATRICK (PT)
Entity Type:Individual
Prefix:MR
First Name:HUNTER
Middle Name:PATRICK
Last Name:BRADSHAW
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 SUMMERWALK RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-1389
Mailing Address - Country:US
Mailing Address - Phone:336-540-8952
Mailing Address - Fax:
Practice Address - Street 1:MOSES CONE HEALTH SYSTEM
Practice Address - Street 2:1200 N ELM STREET
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401
Practice Address - Country:US
Practice Address - Phone:336-832-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist