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Contact Information

BRADLEY P BENGTSON, MD
220 LYON ST NW
STE 700
GRAND RAPIDS, MI49503-2210
 Phone: 616-451-4500
 Fax: 616-451-9077
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for BRADLEY P BENGTSON · (Male)

NPI Number 1447254867
Status Active
Credentials MD
Entity Individual
Enumeration date 06/13/2005
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • MI License # 4301407033
  • MI Medicaid 2746571
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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