Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 4301500919 | MI |
Y | 208600000X | Surgeon | 4301500919 | MI |
NPI | 1003268129 |
---|---|
Provider Name | Brooke Christine Bredbeck |
First Address | Ann Arbor, MI 48109-5346 |
Second Address | Ann Arbor, MI 48109-5346 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/07/2016 |
Last Update Date | 26/01/2021 |