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Individual

DR. BRYAN C WEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
20905 E 12 MILE RD, SUITE 100, ROSEVILLE, MI 48066-6501
(586) 772-3500
(586) 772-6540
Mailing address
20905 E 12 MILE RD, SUITE 100, ROSEVILLE, MI 48066-6501
(586) 772-3500
(586) 772-6540

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
BW002032
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0007767468
AETNA
MI
01
149092
GREAT LAKE HEALTH PLAN
MI
01
38-2777871
TAX ID #
05
4717640
MI
Enumeration date
01/24/2006
Last updated
03/01/2013
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