Individual
DR. BRIAN ELBERT BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
42 N SAINT JOSEPH AVE, SUITE 101, NILES, MI 49120-2203
(269) 684-6696
(269) 684-5286
Mailing address
PO BOX 708, SAINT JOSEPH, MI 49085-0708
(269) 428-5007
(269) 428-2789
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301407413
MI
208600000X
Surgery Physician
M001208
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558317446
—
MI
Enumeration date
05/25/2006
Last updated
12/05/2014
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