Goldberg, Bradley Dean

Goldberg, Bradley Dean is an individual health care provider with primary practice located at 4363 Highland Rd , Waterford MI 48328-2141. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Goldberg, Bradley Dean can be contacted via phone (248) 674-4065.

Contact Information

Primary practice address
4363 Highland Rd Waterford MI 48328-2141
Phone: (248) 674-4065
Fax: (248) 673-4428
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 4901002961 Michigan

Profile Details

NPI number 1740236884
LBN Legal business name Goldberg, Bradley Dean
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated Apr 23rd, 2021 - about 3 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 1740236884 NPPES
Michigan Other 4901002961 MI OPTOMETRY LICENSE
Michigan MEDICAID 0F366959901 MI OPTOMETRY LICENSE

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