Provider Demographics
NPI:1215252481
Name:BRADDY, WHITNEY KERN (MD)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:KERN
Last Name:BRADDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2153 VALLEYGATE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3667
Mailing Address - Country:US
Mailing Address - Phone:910-321-7246
Mailing Address - Fax:910-321-7245
Practice Address - Street 1:2153 VALLEYGATE DR STE 102
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304-3667
Practice Address - Country:US
Practice Address - Phone:910-321-7246
Practice Address - Fax:910-321-7245
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-31
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA268829207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine