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Individual

DR. BRADLEY GEORGE SEWICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
26555 EVERGREEN ROAD, SUITE #830, SOUTHFIELD, MI 48076-4239
(248) 350-3650
(248) 350-1216
Mailing address
26555 EVERGREEN ROAD, SUITE #830, SOUTHFIELD, MI 48076-4239
(248) 350-3650
(248) 350-1216

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
6301005256
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1193960001
MI
Enumeration date
02/06/2007
Last updated
07/08/2007
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