Individual
RYAN W BRADSTREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
(269) 345-1508
Mailing address
900 PEELER ST, KALAMAZOO, MI 49008-2300
(269) 345-8618
(269) 345-1508
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4301116952
MI
207LP3000X
Pediatric Anesthesiology Physician
4301116952
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4301116952
MICHIGAN MD LICENSE
MI
Enumeration date
04/03/2014
Last updated
01/17/2020
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