Provider Demographics
NPI:1962410548
Name:SAMPSON, BRADFORD C (MD)
Entity type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:C
Last Name:SAMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1085 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1547
Mailing Address - Country:US
Mailing Address - Phone:781-331-2922
Mailing Address - Fax:781-335-5702
Practice Address - Street 1:1085 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1547
Practice Address - Country:US
Practice Address - Phone:781-331-2922
Practice Address - Fax:781-335-5702
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2014-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA231101207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology