Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Brian R Bradshaw, MD

Individual provider Dermatology Physician · NPI 1811955800

Brian R Bradshaw, MD is a Dermatology in Provo, Utah. Graduated from University of Utah School of Medicine in 1988, 38 years ago. Practices with Revere Health PC, a 410-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
38
Trained at
University of Utah School of Medicine
Licensed in
UT
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1055 N 500 W Ste 111
Provo, UT 84604-3305
Phone: (801) 374-8999
Fax: (801) 429-8063
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 2806031205 (UT)

Record details

NPI number1811955800
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 2, 2006
Last updated in NPPESNovember 27, 2023
Certification dateAugust 25, 2020
Mailing address1055 N 500 W, Attn: Credentialing, Provo, UT 84604-3305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 1988 (38 years in practice)
Group practice Revere Health Pc — 410 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Provo