Provider Demographics
NPI:1205248937
Name:BRADY, JOHN PAUL IV (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PAUL
Last Name:BRADY
Suffix:IV
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 BROOKLINE AVE STONEMAN 8M
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215
Mailing Address - Country:US
Mailing Address - Phone:617-667-3720
Mailing Address - Fax:
Practice Address - Street 1:330 BROOKLINE AVE STONEMAN 8M
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-7101
Practice Address - Country:US
Practice Address - Phone:617-667-3720
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-29
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD461849207R00000X
CODR.0073046207R00000X, 208M00000X
WV27638207R00000X
MEMD23785207R00000X
MA277057207R00000X, 208M00000X
NH20464208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine