Organization
JOHN D. DINGELL VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY N. AXELROD PH.D. (PSYCHOLOGIST)
(313) 576-1000
Entity
Organization
Contact information
Practice address
4646 JOHN R ST, PSYCHOLOGY SECTION (11MH-PS), DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R, PSYCHOLOGY SECTION (11MH-PS), DETROIT, MI 48201-1916
(313) 576-1000
(313) 576-1091
Taxonomy
Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary
6301007688
MI
Other
Enumeration date
08/17/2006
Last updated
08/22/2020
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