STEPHEN JEROME BRADLEY (NPI# 1164455028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164455028 |
| Entity Type | Individual |
| Full Name | STEPHEN JEROME BRADLEY |
| Credential | M.D. |
| Practice Address |
4160 John R St Ste 615 Detroit MI 48201-2020 |
| Mailing Address |
1560 E Maple Rd Suite 400 - Credentialing Department Troy MI 48083-1138 |
| Practice Telephone | 3137454195 |
| Practice Fax Number | 3137458669 |
| Mailing Telephone | 3137454195 |
| Mailing Fax Number | 3139938669 |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2016-10-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 4301050040 | MI | Allopathic & Osteopathic Physicians |
| Y | 2086S0102X |
Surgery Specialization: Surgical Critical Care |
4301050040 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 020017324 | 01 | |
| IL | 036078462 | 05 | |
| WI | 31523400 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457455024 | Stephen E Bradley | Dentist | 821 24th Ave Nw, Norman, OK 73069-6313 | 2006-09-12 |
| 1134222011 | Stephen Bradley | Physician Assistant | 740 Memorial St, Prosser, WA 99350-1525 | 2006-09-06 |
| 1699746446 | Stephen Peter Bradley | Family Medicine | 5375 Lakeshore Blvd, Lakeport, CA 95453-6123 | 2006-01-30 |
| 1588036982 | Stephen Bradley | Pharmacist | 1896 Route 6, Carmel, NY 10512-2355 | 2015-10-24 |
| 1861700734 | Stephen Bradley | Counselor | 419 E 7th St Ste 207, The Dalles, OR 97058-2676 | 2010-09-14 |
| 1558505537 | Stephen Ralph Bradley | Dentist | 307 Maple Ave W, Suite G, Vienna, VA 22180-4307 | 2009-04-22 |
| 1972671261 | Stephen James Bradley | Counselor | 8 Trumbull Rd, Suite 202, Northampton, MA 01060-3079 | 2006-12-02 |
| 1295825651 | Stephen P Bradley | General Practice | 86-260 Farrington Hwy, Waianae, HI 96792-3128 | 2006-10-13 |
| 1508950296 | Stephen K Bradley | Anesthesiology | 9660 South 1300 East, Alta View Hospital, Sandy, UT 84094 | 2006-10-03 |
| 1699874644 | Stephen P. Bradley | Internal Medicine | 10666 N Torrey Pines Rd, La Jolla, CA 92037-1027 | 2006-09-22 |
| Street Address |
4160 JOHN R ST STE 615 |
| City | DETROIT |
| State | MI |
| Zip Code | 48201-2020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508864240 | Uma D Gorrepati | Internal Medicine | 4160 John R St, Suite 730, Detroit, MI 48201-2020 | 2005-07-07 |
| 1306466826 | Joseph Trak | Student in an Organized Health Care Education/Training Program | 4160 John R St, Suite 615, Detroit, MI 48201 | 2020-04-24 |
| 1437717097 | Fauzia Zubair Arain | Student in an Organized Health Care Education/Training Program | 4160 John R St, Detroit, MI 48201-2020 | 2019-05-30 |
| 1821520495 | Yang Liu | Student in an Organized Health Care Education/Training Program | 4160 John R St, Suite 615, Detroit, MI 48201-2020 | 2017-04-01 |
| 1053859256 | Karin Calviti | Audiologist | 4160 John R St, Detroit, MI 48201-2020 | 2017-02-07 |
| 1932551348 | Ayman Abulawi | Student in an Organized Health Care Education/Training Program | 4160 John R St, Suite 510, Detroit, MI 48201-2020 | 2016-07-09 |
| 1407204027 | Amir Laktineh | Student in an Organized Health Care Education/Training Program | 4160 John R St, 510, Detroit, MI 48201-2020 | 2016-05-25 |
| 1801243548 | Mohannad Alhasani | Internal Medicine | 4160 John R St, Suite 510, Detroit, MI 48201-2020 | 2016-05-23 |
| 1073976353 | Catherine Peterson | Student in an Organized Health Care Education/Training Program | 4160 John R St, Suite 930, Detroit, MI 48201-2020 | 2016-04-03 |
| 1598128902 | Aubrey Brian Allen | Student in an Organized Health Care Education/Training Program | 4160 John R St, 1021, Detroit, MI 48201-2020 | 2016-04-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659989838 | Saima Sharif | Student in an Organized Health Care Education/Training Program | 4201 St Antoine St 9c-uhc Detroit Education & Research, Detroit, MI 48201 | 2020-07-14 |
| 1609494384 | Praveen Kumar Boddu | Student in an Organized Health Care Education/Training Program | 3901,beaubien, Ste 3t72, Children's Hospital, Detroit, MI 48201 | 2020-07-09 |
| 1730707720 | Amr Hassan Abdelghaffar Omar | Pediatrics | 3901 Beaubien St Room 3t72, Children's Hospital of Michigan, Detroit, MI 48201 | 2020-07-07 |
| 1700400694 | Hassan Imtiaz | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine 8c-uhc, Detroit Medical Center, Detroit, MI 48201 | 2020-06-05 |
| 1598389074 | Alaa Awad Elkarim | Student in an Organized Health Care Education/Training Program | 3901 Beaubien St. 3t72, Detroit, MI 48201 | 2020-06-01 |
| 1891319299 | Jeongyeon Hwang | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street University Health Center - 8c, Detroit, MI 48201 | 2020-06-01 |
| 1477176576 | Jaudat Fatima Masood | Student in an Organized Health Care Education/Training Program | 4201 St Antoine Street, University Health Center - 8c, Detroit, MI 48201 | 2020-05-22 |
| 1205459419 | Amit Kumar Dahiya | Student in an Organized Health Care Education/Training Program | 11201 St. Antoine, Room 2e Uhc, Detroit, MI 48201 | 2020-05-21 |
| 1851914188 | Asra Nausheen Shaik | Student in an Organized Health Care Education/Training Program | 4201 St. Antoine St, Room 2e-uhc, Detroit, MI 48201 | 2020-05-21 |
| 1568085751 | Camille Olechowski | Student in an Organized Health Care Education/Training Program | 3901 Chrysler Dr. Detroit Medical Center, Room 5-a 538.1, Detroit, MI 48201 | 2020-05-21 |
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| Taxonomy Code | 2086S0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Surgical Critical Care |
| A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659371326 | Marc L. Cullen | Surgery | Childrens Hospital of Michigan, 3901 Beaubien Blvd, Detroit, MI 48201 | 2005-07-26 |
| 1154863033 | United Critical Care Plc | Surgery | 6071 W Outer Dr, Detroit, MI 48235-2624 | 2016-11-09 |
| 1316000938 | Scott A. Dulchavsky | Surgery | 2799 W Grand Blvd, Detroit, MI 48202-2608 | 2006-12-18 |
| 1043373665 | Anthony J. Falvo | Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2006-12-18 |
| 1770646390 | Harriette M. Horst | Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2006-12-18 |
| 1679636203 | Aml M. Raafat | Surgery | Henry Ford Health System, 2799 West Grand Boulevard, Detroit, MI 48202 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467748210 | John Dillon Galbraith | Surgery | 100 Michigan St Ne Ste A501, Grand Rapids, MI 49503 | 2011-06-21 |
| 1215127501 | Vinod K Puri | Surgery | 16001 W. Nine Mile Rd, Providence Hospital, Southfield, MI 48075 | 2007-08-01 |
| 1215090840 | Michael S. Malian | Surgery | 18101 Oakwood Boulevard, Beaumont Hospital, Dearborn Trauma Svcs, Dearborn, MI 48123 | 2006-12-18 |
| 1164594420 | James E Hoogeboom | Surgery | 6290 Burton St Se, Grand Rapids, MI 49546-6775 | 2006-11-14 |
| 1699870865 | St. Marys of Michigan Specialists | Surgery | 4690 Mcleod Dr E, Ste B, Saginaw, MI 48604-2836 | 2006-09-13 |
| 1518522093 | Jamal D Farhan, M.d., P.C. | Surgery | 1020 Charter Dr Ste A, Flint, MI 48532-3584 | 2019-05-09 |
| 1306386586 | W.a. Foote Memorial Hospital, Inc | Surgery | 205 N East Ave, Jackson, MI 49201-1753 | 2017-03-07 |
| 1578941969 | John R Montgomery | Surgery | 1500 E Medical Center Dr, 2110 Tc, Spc 5346, Ann Arbor, MI 48109-5000 | 2015-05-18 |
| 1528477387 | Kailyn Sum York Lain Kwong Hing | Surgery | 221 Michigan St Ne Ste 400, Grand Rapids, MI 49503-2538 | 2014-08-06 |
| 1609167063 | Jeffrey C Walker | Surgery | 5301 Mcauley Drive, Trauma & Surgical Critical Care, Ypsilanti, MI 48197-5033 | 2011-04-20 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.