Individual
BRADLEY JOHN MICHIELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1001 SAM PERRY BLVD, JEAN LOCKEY, FREDERICKSBURG, VA 22401-4453
(540) 741-7614
(919) 873-9821
Mailing address
3100 SPRING FOREST RD, RALEIGH, NC 27616-2880
(888) 280-9533
(919) 873-9821
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0101054110
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790776052
—
VA
Enumeration date
11/04/2005
Last updated
06/23/2015
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