Willoughby, Bradley L

Willoughby, Bradley L is an individual health care provider with primary practice located at 577 Michigan Ave Suite 201, Holland MI 49423-4911. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Willoughby, Bradley L can be contacted via phone (616) 392-1816.

Contact Information

Primary practice address
577 Michigan Ave Suite 201 Holland MI 49423-4911
Phone: (616) 392-1816
Fax: (616) 392-1292
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 4301052455 Michigan

Profile Details

NPI number 1891790507
LBN Legal business name Willoughby, Bradley L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2005
Last updated Jul 29th, 2015 - about 9 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 1891790507 NPPES
Other 1952507444 GROUP NPI

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