Search › Michigan › 103T00000X
Bradford Wilson, TLLP
NPI 1396081451 · on the registry since 2012
Practice
- Address
- 5675 Fairview St
Stevensville, MI 49127 - Phone
- (269) 429-7727
- Fax
- (269) 429-5754
- Organisation at this address
- Lakeland Medical Practices
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 16
Additional practice sites
- 133 W Main St, Benton Harbor, MI
Registry record
- Primary taxonomy
- 103T00000X
103T00000X
- Also registered as
- 101Y00000X
101Y00000X - Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-02-10
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan