Bastow, Bradley D

Bastow, Bradley D is an individual health care provider with primary practice located at 950 Blue Star Hwy Suite 1-2, South Haven MI 49090-7759. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Bastow, Bradley D can be contacted via phone (269) 637-1388.

Contact Information

Primary practice address
950 Blue Star Hwy Suite 1-2 South Haven MI 49090-7759
Phone: (269) 637-1388
Fax: (269) 637-1459
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 5101008849 Michigan

Profile Details

NPI number 1346221082
LBN Legal business name Bastow, Bradley D
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346221082 NPPES
Michigan MEDICAID 3449722

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