Bengtson, Bradley Paul

Bengtson, Bradley Paul is an individual health care provider with primary practice located at 220 Lyon St Nw Ste 700, Grand Rapids MI 49503-2210. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Bengtson, Bradley Paul can be contacted via phone (616) 451-4500.

Contact Information

Primary practice address
220 Lyon St Nw Ste 700 Grand Rapids MI 49503-2210
Phone: (616) 451-4500
Fax: (616) 451-9077
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 4301407033 Michigan

Profile Details

NPI number 1447254867
LBN Legal business name Bengtson, Bradley Paul
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Jul 8th, 2007 - about 17 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 1447254867 NPPES
Michigan MEDICAID 2746571

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