Individual
DR. BRADLEY MARK BOELKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3271 CLEAR VISTA CT NE, GRAND RAPIDS, MI 49525-9477
(616) 267-7125
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
4301502619
MI
207R00000X
Internal Medicine Physician
4301502619
MI
Other
Enumeration date
04/06/2015
Last updated
06/28/2021
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