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NICHOLAS BRADLEE DPM PC NPI 1497860464


NPI Information

NPI: 1497860464
Provider Name: NICHOLAS BRADLEE DPM PC
Classification: Podiatrist - 213E00000X
Entity Type: Organization
Address:
1909 LIVERNOIS
TROY, MI
ZIP 48083
Phone: (248) 244-9565
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NICHOLAS BRADLEE DPM PC is a podiatrist in Troy, MI. The provider is a podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. NICHOLAS BRADLEE DPM PC NPI is 1497860464. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1909 LIVERNOIS
TROY, MI
ZIP 48083
Phone: (248) 244-9565
Fax: (248) 244-8183

The provider's authorized official is Nicholas Bradlee .
The authorized official title is Owner and has the following contact phone number (248) 244-9565.

The enumeration date for this NPI number is 8/20/2006 and was last updated on 11/20/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1213E00000XPodiatristNB000558MICHIGANYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
18505050OTHERBLUE SHIELD OF MICH
2OP19590MEDICARE PIN
35635277OTHERBLUE CROSS
48505050OTHERBLUE CROSS BLUE SHIELD
55635277OTHERBLUE CROSS BLUE SHIELD
65983140002MEDICARE NSCMICHIGAN
7T34175MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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