Provider Demographics
NPI:1356347546
Name:BRADY, JOHN PATRICK (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:BRADY
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 1:3100 VILLAGE POINT
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-9689
Mailing Address - Country:US
Mailing Address - Phone:219-395-1046
Mailing Address - Fax:219-395-1570
Practice Address - Street 1:3100 VILLAGE POINT
Practice Address - Street 2:SUITE 102
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-9689
Practice Address - Country:US
Practice Address - Phone:219-395-1046
Practice Address - Fax:219-395-1570
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2010-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01040551A207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology