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1215010863
BRADLEY WAYNE MONGOLD
MARTINSBURG, WV
NPI
1215010863
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: NV 21986)
Enumeration Date
2006-10-24
Last Update Date
2010-03-29
Business Address
-- BRADLEY WAYNE MONGOLD MD
2500 HOSPITAL DRIVE
MARTINSBURG, WV 25401
Phone number: 304-264-1000
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Mailing Address
-- BRADLEY WAYNE MONGOLD MD
PO BOX 1150
MARTINSBURG, WV 25402-1150
Phone number: 304-264-1000
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