BRYCE XAVIER BREDELL (NPI# 1205332483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205332483 |
Entity Type | Individual |
Full Name | BRYCE XAVIER BREDELL |
Credential | MD |
Practice Address |
6071 E Outer Dr Detroit MI 48234 |
Mailing Address |
943 Nottingham Rd Grosse Pointe Park MI 48230-1733 |
Practice Telephone | 3139661020 |
Practice Fax Number | 3139661024 |
Mailing Telephone | 7346454000 |
Enumeration Date | 2018-04-05 |
Last Update Date | 2018-04-05 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
Street Address |
6071 E OUTER DR |
City | DETROIT |
State | MI |
Zip Code | 48234 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538668595 | Constance Durden | Social Worker | 19940 Conant Suite B, Detroit, MI 48234 | 2018-02-06 |
1891217717 | Donald Williams | Case Manager/Care Coordinator | 19133 Hasse, Detroit, MI 48234 | 2017-07-12 |
1063865830 | Gloria A. Love | Psychologist | 19677 Revere, Detroit, MI 48234 | 2016-07-18 |
1972977429 | Conant Garden Dental Center Dds PC | Dentist | 2430 E Seven Mile, Suite 6, Detroit, MI 48234 | 2015-11-20 |
1861878787 | Kenyatta Philips | Chore Provider | 20119 Helen St, Detroit, MI - MICHIGAN 48234 | 2015-08-03 |
1083977144 | Edward Powell | Counselor | 19436 Packard Street, Detroit, MI 48234 | 2012-06-22 |
1487931325 | Sonia Renee George | Case Manager/Care Coordinator | 8331 Yolanda St., Detroit, MI 48234 | 2011-11-07 |
1851682215 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 19211 Anglin, Detroit, MI 48234 | 2011-04-20 |
1558662742 | Tenille Daniel | Home Health | 17210 Runyon, Detroit, MI 48234 | 2010-11-04 |
1891959607 | Janis Brantley | Registered Nurse | 5400 East 7 Mile, Northeast Health Center Room 17, Detroit, MI 48234 | 2008-07-11 |
Find all providers in zip 48234 |
Taxonomy Code | 390200000X |
Grouping | Student, Health Care |
Classification | Student in an Organized Health Care Education/Training Program |
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
Notes: [1/1/2005: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013514702 | Leeza Fortner | Student in an Organized Health Care Education/Training Program | 259 Mack Ave Ste 4514, Detroit, MI 48201-2427 | 2020-10-06 |
1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
1912516790 | Omar Choudhury | Student in an Organized Health Care Education/Training Program | Henroy Ford Hospital, Medical Education Department ., 2799 W. Grand Boulevard, Detroit, MI 48202-2608 | 2020-07-28 |
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 |
1932725959 | Devonn Eli Israil | Student in an Organized Health Care Education/Training Program | 4201 Saint Antoine St Rm 2d, Detroit, MI 48201-2153 | 2020-06-25 |
1457976292 | Ali Nauman Khan | Student in an Organized Health Care Education/Training Program | Detroit Medical Center-sinai Grace Hospital, 6071 W. Outer Driver, Detroit, MI 48235 | 2020-06-08 |
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 |
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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.