Individual
BRAD VAMPLEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
31157 WOODWARD AVE, ROYAL OAK, MI 48073-0996
(248) 336-0123
Mailing address
13716 LEROY ST, SOUTHGATE, MI 48195-3112
(734) 341-1671
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601009537
MI
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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