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Individual

BRADFORD BITTNER WYLIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7093 DEXTER ANN ARBOR RD, DEXTER, MI 48130-8568
(734) 426-9028
(734) 426-9029
Mailing address
24 FRANK LLOYD WRIGHT DR LBBY J2000, ANN ARBOR, MI 48105-9484
(734) 747-6766

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301067908
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1108127972
BCBS
MI
05
459558310
MI
Enumeration date
12/19/2005
Last updated
05/28/2020
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