Dr. Bradley Mark Boelkins
Internist Allergist & Immunologist
3271 Clear Vista Ct Ne
Grand Rapids
, Michigan 49525-9477
Dr. Bradley Mark Boelkins
Internist Allergist & Immunologist
3271 Clear Vista Ct Ne
Grand Rapids
, Michigan 49525-9477
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About
Features
Specialties
- Allergist & Immunologist
- Internist
Languages spoken
- English
Location
First Address
- Dr. Bradley Mark Boelkins
- 100 Michigan St Ne # Mc845
- Grand Rapids, MI
- Zip : 49503-2560
- Phone :
Second Address
- Dr. Bradley Mark Boelkins
- 3271 Clear Vista Ct Ne
- Grand Rapids, MI
- Zip : 49525-9477
- Phone : (616) 267-7125
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207K00000X | Allergist & Immunologist | 4301502619 | MI |
| N | 207R00000X | Internist | 4301502619 | MI |
| N | 111NI0900X | Internist | 4301502619 | MI |
National Provider Identifier
| NPI | 1073908091 |
|---|---|
| Provider Name | Dr. Bradley Mark Boelkins |
| First Address | Grand Rapids, MI 49503-2560 |
| Second Address | Grand Rapids, MI 49525-9477 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/04/2015 |
| Last Update Date | 28/06/2021 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.