Provider Demographics
NPI:1992747703
Name:WAY, BRADY C (MD)
Entity type:Individual
Prefix:
First Name:BRADY
Middle Name:C
Last Name:WAY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3325 PIEDMONT RD NE
Mailing Address - Street 2:BLDG 7-601
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1889
Mailing Address - Country:US
Mailing Address - Phone:404-842-5600
Mailing Address - Fax:404-848-8611
Practice Address - Street 1:210 PENNY LN
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-4305
Practice Address - Country:US
Practice Address - Phone:252-247-4769
Practice Address - Fax:252-247-0948
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2010-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC20985208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
020017133OtherRAILROAD MEDICARE NUMBER
NC8986054Medicaid
NC86054OtherNC BCBS NUMBER
NC8986054Medicaid
020017133OtherRAILROAD MEDICARE NUMBER