Individual
DR. BRADLEY THOMAS WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
275 MICHIGAN ST NE FL 9, GRAND RAPIDS, MI 49503-2531
(616) 391-3777
Mailing address
275 MICHIGAN ST NE FL 9, GRAND RAPIDS, MI 49503-2531
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4351051375
MI
208000000X
Pediatrics Physician
4351051375
MI
Other
Enumeration date
04/04/2023
Last updated
04/02/2025
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