Provider Demographics
NPI:1184779969
Name:SWITZER, BRADLEY ALAN (MD)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:ALAN
Last Name:SWITZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:BRAD
Other - Middle Name:A
Other - Last Name:SWITZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 415348
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-5348
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:55 LAKE AVE. N
Practice Address - Street 2:
Practice Address - City:WORRESTER
Practice Address - State:MA
Practice Address - Zip Code:01655
Practice Address - Country:US
Practice Address - Phone:508-334-3550
Practice Address - Fax:508-334-6294
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA233914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine