# DR. MICHELLE RENAE BRADLEY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1003015314
- **Gender:** F
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 14577 | ND | Yes |
| 207Q00000X | Family Medicine Physician | 52168 | MN | — |
| 207Q00000X | Family Medicine Physician | PT14577 | ND | — |

## Other

- **Enumeration date:** 07/16/2007
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 036940100 | — | MN |