Provider Demographics
NPI:1669636965
Name:WHITMER, BRADFORD A (DO)
Entity Type:Individual
Prefix:DR
First Name:BRADFORD
Middle Name:A
Last Name:WHITMER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:26901 BEAUMONT BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:947-522-1848
Mailing Address - Fax:947-522-0307
Practice Address - Street 1:25631 LITTLE MACK AVE STE 205
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2108
Practice Address - Country:US
Practice Address - Phone:586-443-2380
Practice Address - Fax:586-443-2940
Is Sole Proprietor?:No
Enumeration Date:2008-07-15
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101017745207R00000X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine