Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRADLEY T DEWALL, MD
Active Sole ProprietorSpecialist · LE CLAIRE, IA
Registration Details
- NPI Number
- 1255427597
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 5, 2006 (19.56391608336 yrs)
- Last Updated
- Jun 21, 2019
- License
-
21364 (IA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
21985 277TH AVELE CLAIRE, IA, 52753Browse IA providers · Browse ZIP 52753
- Phone
- 5635086330
- Primary Specialty
-
Specialist
174400000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.