BRADLEY ROBERT PETERS (NPI# 1659374262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1659374262 |
Entity Type | Individual |
Full Name | BRADLEY ROBERT PETERS |
Credential | M.D. |
Practice Address |
200 Oakside Ln Ste A Canton GA 30114-6416 |
Mailing Address |
5655 Hudson Dr Ste 210 Aris Radiology Hudson OH 44236-4455 |
Practice Telephone | 7704791945 |
Practice Fax Number | 7704791948 |
Mailing Telephone | 3306551869 |
Mailing Fax Number | 3306553828 |
Enumeration Date | 2005-05-27 |
Last Update Date | 2016-11-10 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
26644 | AL | Allopathic & Osteopathic Physicians |
N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
202673 | NY | Allopathic & Osteopathic Physicians |
Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
051890 | GA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
GA | 000964268L | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396343356 | Bradley Peters | Pharmacist | 150 Western Ave Nw, Faribault, MN 55021-4504 | 2020-10-13 |
1649627266 | Bradley Peters | Counselor | 1310 Valley View Blvd, Altoona, PA 16602 | 2016-05-24 |
1750529087 | Bradley Christopher Peters | Social Worker | 343 S Kirkwood Rd, Saint Louis, MO 63122-6195 | 2009-01-23 |
Street Address |
200 OAKSIDE LN STE A |
City | CANTON |
State | GA |
Zip Code | 30114-6416 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1457640831 | Canton Specialty Imaging, LLC | Specialist | 200 Oakside Ln, Suite A, Canton, GA 30114-6416 | 2011-04-06 |
1306086228 | Kennestone Heart Physicians Group | Internal Medicine | 200 Oakside Ln, Suite D, Canton, GA 30114-6416 | 2009-03-05 |
1588774467 | Teru Kay Lapaquette | Obstetrics & Gynecology | 200 Oakside Ln, Suite D, Canton, GA 30114-6416 | 2006-08-30 |
1932155355 | Imaging Associates of Canton | Clinic/Center | 200 Oakside Ln, Suite A, Canton, GA 30114-6415 | 2006-05-26 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1619516093 | Wickshire Canton Opco LLC | Assisted Living Facility | 125 Riverstone Terrace, Canton, GA 30114 | 2020-01-02 |
1154803583 | Alixandra Nicole Flournoy | Physical Therapist | 131 Holly Street, Canton, GA 30114 | 2018-09-01 |
1588157341 | Provident Group - Canton Cove Properties LLC | Alzheimer Center (Dementia Center) | 1100 Reinhardt College Parkway, Canton, GA 30114 | 2018-06-07 |
1003233107 | Heartland Dental Care of Georgia | Dentist | 3237 Sixes Rd, Canton, GA 30114 | 2014-03-26 |
1730510959 | Joseph Optical | Eyewear Supplier (Equipment, not the service) | 1455 Riverstone Pkwy Suite 110, Canton, GA 30114 | 2013-12-13 |
1629313036 | Ramona Morton Rasmussen | Occupational Therapist | 200 Riverstone Drive, Suite B, Canton, GA 30114 | 2012-12-11 |
1902154875 | Yong Qiao Luo | Acupuncturist | 200 Oakside Lane, Suite D, Canton, GA 30114 | 2012-08-26 |
1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
1558638981 | Stephen E Byrd | Counselor | 191 Lamar Haley Pkwy., Canton, GA 30114 | 2011-11-30 |
1073807855 | Sheri Sullins Buckley | Nurse Practitioner | 120 Oakside Ct Ste H, Canton, GA 30114 | 2011-06-08 |
Find all providers in zip 30114 |
Taxonomy Code | 2085R0202X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Diagnostic Radiology |
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578061636 | Subspecialty Imaging, LLC | Radiology | 1495 Hickory Flat Hwy Ste 150, Canton, GA 30115-4229 | 2018-01-24 |
1649566183 | Guillermo Zaldivar | Radiology | 6877 Chillingsworth Cir Nw, Canton, OH 44718-1571 | 2011-06-23 |
1417113044 | Adnan Ali Fateh | Radiology | 42186 Saratoga Cir, Canton, MI 48187-3535 | 2008-08-04 |
1861560013 | Radiology Services of Stark County Inc | Radiology | 4525 Saint James Cir Nw, Canton, OH 44708-8902 | 2006-12-04 |
1396751426 | Jennifer Elizabeth Bryant | Radiology | 36 Hoffmann Rd, Canton, CT 06019-2123 | 2006-07-31 |
1144280397 | Maria Crumes M.d. P.C. | Radiology | 49086 Crescent Dr, Canton, MI 48187-6671 | 2006-03-23 |
1154784619 | On-demand Provider PC | Radiology | 44237 Michigan Ave, Canton, MI 48188-2584 | 2016-04-01 |
1558755843 | Stephen A. Snodgrass | Radiology | 2600 6th St Sw, Canton, OH 44710-1702 | 2015-03-24 |
1841633351 | David Angari | Radiology | 2600 Sixth St Sw, Canton, OH 44710-1702 | 2013-04-15 |
1194168989 | Anirudh Paspulati | Radiology | 2600 Sixth St Sw, Canton, OH 44710-1702 | 2013-04-10 |
Find all providers in CANTON |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.