Bradley Bengtson, M.d. Pc

NPI 1013234707 - Plastic Surgery - 208200000X

NPI Details
NPI 1013234707
Enumeration Date 04/21/2010
Last Updated 04/21/2010
Entity Type Healthcare Provider
Active Over 6 years ago
Authorized Information
Name BRADLEY BRADLEY
Position OWNER
Phone (616) 588-8880
Fax (616) 588-8881
Practice Location
555 MIDTOWNE ST NE
SUITE 110
GRAND RAPIDS MI, 49503-5729, US
Phone (616) 588-8880
Fax (616) 588-8881
Business Location
555 MIDTOWNE ST NE
SUITE 110
GRAND RAPIDS MI, 49503-5729, US
Phone (616) 588-8880
Fax (616) 588-8881
Toxanomy
Taxonomy Code 208200000X
License State Michigan
License Number 4301407033
Remove 1013234707 NPI Number
 

According to our database, Bradley Bengtson, M.d. Pc NPI is 1013234707, taxonomy code is 208200000X and license number is 4301407033, license state is located at Michigan. Bradley Bengtson, M.d. Pc physically located at 555 Midtowne St Ne, Grand Rapids MI, 49503-5729. NPI Number 1033115704 has the healthcare provider type.

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1013234707 NPI number is provided on an as is basis without warranty of any kind. 1013234707 is maintained by the National Plan & Provider Enumeration System. The contents of Bradley Bengtson, M.d. Pc are for informational purposes only.