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Individual

BRADLEY ADAM DEMIJOHN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3225 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525-9334
(616) 364-1500
Mailing address
300 68TH ST SE, GRAND RAPIDS, MI 49548-6927
(616) 456-0842
(616) 559-5864

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301505196
MI
2084P0800X
Psychiatry Physician
4351044077
MI
2084P0804X
Child & Adolescent Psychiatry Physician
4301505196
MI

Other

Enumeration date
04/08/2019
Last updated
06/26/2024
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