Individual
BRADLEY PETER BEKKUM SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
500 E VETERANS ST, TOMAH, WI 54660-3105
(608) 372-3971
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
41128
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32565700
—
WI
Enumeration date
08/24/2006
Last updated
12/13/2023
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