IndividualActive
Brian Bradshaw, MD
NPI 1811955800 · Dermatology Physician · Provo, UT
Provider details
- NPI number
- 1811955800
- Entity type
- Individual
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 2806031205 (UT)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1055 N 500 W
Suite 111
Provo, UT 84604-3305
Phone: (801) 374-8999
Fax: (801) 429-8063
Approximate (ZIP-level) locationGet directions
Mailing address
1055 N 500 W
Provo, UT 84604-3305
Registry dates
- Enumerated
- 2006-05-02
- Last updated
- 2023-11-27
- Certified
- 2020-08-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.