Evans, Bradley K.
Evans, Bradley K. is an individual health care provider with primary practice located at 110 S Madison St , Traverse City MI 49684-2340. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Evans, Bradley K. can be contacted via phone (231) 935-0340.Contact Information
Primary practice address
110 S Madison St
Traverse City MI 49684-2340
Phone: (231) 935-0340
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | BE062479 | Michigan |
Profile Details
| NPI number | 1255356523 |
|---|---|
| LBN Legal business name | Evans, Bradley K. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2006 |
| Last updated | Nov 24th, 2020 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255356523 | NPPES |
| Michigan | Other | 1302845381 | BLUE CROSS BLUE SHIELD OF MICHIGAN |
| Michigan | MEDICAID | 3067916 | BLUE CROSS BLUE SHIELD OF MICHIGAN |
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