# JEREMY BRADFORD PETROUS

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

## Provider details

- **NPI number:** 1639584196
- **Gender:** Man
- **Credential:** DO

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | 5101021240 | MI | Yes |
| 2084P0800X | Psychiatry Physician | 5101021240 | MI | — |

## Other

- **Enumeration date:** 06/24/2014
- **Last updated:** 02/25/2021