Provider Demographics
NPI:1356721096
Name:BRADY, MARGARET STAFFORD (MD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:STAFFORD
Last Name:BRADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARGARET
Other - Middle Name:
Other - Last Name:STAFFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9313 MEDICAL PLAZA DR STE 103
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9802
Mailing Address - Country:US
Mailing Address - Phone:843-790-8280
Mailing Address - Fax:843-974-8500
Practice Address - Street 1:9313 MEDICAL PLAZA DR STE 103
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9802
Practice Address - Country:US
Practice Address - Phone:843-790-8280
Practice Address - Fax:843-974-8500
Is Sole Proprietor?:No
Enumeration Date:2015-06-08
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC38303207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC383034Medicaid