Bradley C Brenton, M.D.
Individual provider Active NPI Body Imaging Physician · Goldsboro, NC
NPI 1083676738 · NPPES record last updated Nov 29, 2011
Key facts
- NPI
- 1083676738
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Body Imaging Physician 2085B0100X
- License
- 24637 (NC)
- Practice address
- 2700 Medical Office PL
Goldsboro, NC 27534-9460 - Phone
- (919) 734-1866
- Fax
- (919) 736-1804
- NPI assigned
- Apr 6, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Body Imaging Physician | 2085B0100X | 24637 | NC | Yes |
Addresses
Primary practice location
2700 Medical Office PL
Goldsboro, NC 27534-9460
Mailing address
PO Drawer 1757
Goldsboro, NC 27533
Phone (919) 734-1866
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02898 | Other | NC | WORK COMP |
| 14876 | Other | NC | BCBS NC STATE |
| 8914876 | Medicaid | NC | |
| 14876 | Other | NC | BCBS |
Other providers in Goldsboro, NC
- Amy G. E. Brantley
- Philip K Brantly
- Breath of Life, Inc.
- Anissa Sheree Breland
- Brenda a. Taylor
- Hannah Elisabeth Brewer
- Albert L Bridger
- Bridges of Hope Inc
- Bridgewell Residential Services, LLC
- Bridging the Gap Home Health Care Services, LLC
All providers in Goldsboro, NC · Body Imaging Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.