BRADLEY D BASTOW (NPI# 1346221082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346221082 |
| Entity Type | Individual |
| Full Name | BRADLEY D BASTOW |
| Credential | D.O. |
| Practice Address |
950 Blue Star Hwy Suite 1-2 South Haven MI 49090-7759 |
| Practice Telephone | 2696371388 |
| Practice Fax Number | 2696371459 |
| Mailing Telephone | 2696371388 |
| Mailing Fax Number | 2696371459 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
5101008849 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 3449722 | 05 |
| Street Address |
950 BLUE STAR HWY SUITE 1-2 |
| City | SOUTH HAVEN |
| State | MI |
| Zip Code | 49090-7759 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740559871 | Card Prop Corp | Internal Medicine | 950 Blue Star Hwy, Suite 1-2, South Haven, MI 49090-7759 | 2011-12-19 |
| 1669786158 | Robert Edward Quinlan Jr. | Internal Medicine | 950 Blue Star Hwy, Suite 1-2, South Haven, MI 49090-7759 | 2010-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295234490 | Katara Therapy, LLC | Social Worker | 13560 76th Street, Suite 3, South Haven, MI 49090 | 2018-02-03 |
| 1487022091 | Kevin E. Ferrell | Physician Assistant | 955 S. Bailey Avenue, South Haven, MI 49090 | 2015-09-14 |
| 1942638002 | Birdie Farley | Chore Provider | 26725 M-140 Hwy, South Haven, MI 49090 | 2013-10-28 |
| 1730514910 | Rebecca A. Bennett | Counselor | 1675 Phoenix Road, Suite 9, South Haven, MI 49090 | 2013-09-06 |
| 1902149818 | Bronson South Haven Hospital | Emergency Medicine | 970 S Bailey Ave, South Haven, MI 49090 | 2013-03-28 |
| 1265629927 | Cecilia Liz Vives Vasquez | Physical Therapist | 23701 Red Arrow Hwy, Mattawan, MI 49090 | 2007-09-26 |
| 1518089788 | Donald Jam,es Buckley | Pharmacist | 955 S Bailey, South Haven, MI 49090 | 2007-04-06 |
| 1366568966 | Norman M Maly | Dentist | 05055 Blue Star Hwy, South Haven, MI 49090 | 2007-03-22 |
| 1639264062 | Deborah Sue Distefano | Pharmacy Technician | 512 Phoenix Street, South Haven, MI 49090 | 2006-10-03 |
| 1053357897 | Stephen Earl Tolen | Chiropractor | 325 Superior St., South Haven, MI 49090 | 2006-06-21 |
| Find all providers in zip 49090 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477154458 | Spectrum Health Primary Care Partners | Internal Medicine | 749 Phillips St, South Haven, MI 49090-1842 | 2020-11-05 |
| 1861571747 | Cardiology II, P.C. | Internal Medicine | 950 Blue Star Memorial Hwy, Suite 1, South Haven, MI 49090-7335 | 2006-11-03 |
| 1750320958 | Brian A Akrami | Internal Medicine | 965 S Bailey Ave, South Haven, MI 49090-6743 | 2006-06-05 |
| 1740559871 | Card Prop Corp | Internal Medicine | 950 Blue Star Hwy, Suite 1-2, South Haven, MI 49090-7759 | 2011-12-19 |
| 1669786158 | Robert Edward Quinlan Jr. | Internal Medicine | 950 Blue Star Hwy, Suite 1-2, South Haven, MI 49090-7759 | 2010-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902413891 | Atria Vascular & Vein, Pllc | Internal Medicine | 32255 Northwestern Hwy Ste 115a, Farmington Hills, MI 48334-1566 | 2020-09-25 |
| 1538785415 | Lakes Cardiology PC | Internal Medicine | 9640 Commerce Rd Ste 106, Commerce Twp, MI 48382-4167 | 2020-06-17 |
| 1811468895 | Telemedico Physicians of Michigan | Internal Medicine | 24359 Northwestern Hwy Ste 200, Southfield, MI 48075-2597 | 2018-12-17 |
| 1639644305 | Metropolitan Cardiovascular | Internal Medicine | 28667 Bayberry Ct E, Livonia, MI 48154-3869 | 2018-10-09 |
| 1194202234 | Mvp Endovascular Center Pllc | Internal Medicine | 22720 Michigan Ave Ste 300, Dearborn, MI 48124-2035 | 2018-07-22 |
| 1366992059 | Renew Research LLC | Internal Medicine | 26800 Haggerty Rd, Farmington Hills, MI 48331-5715 | 2016-10-06 |
| 1972051530 | Michael Abdul-malek Do Pllc | Internal Medicine | 1380 Coolidge Hwy Ste 250, Troy, MI 48084-7067 | 2016-09-13 |
| 1205389384 | Elite Medical Enterprises, Inc. | Internal Medicine | 7750 Schaefer Rd Ste 202, Dearborn, MI 48126-1159 | 2016-07-26 |
| 1265803316 | Alpine Cardiology, Pllc | Internal Medicine | 101 E Mitchell St, Gaylord, MI 49735-1460 | 2015-10-15 |
| 1043618143 | Cardiology Care Consultants Pllc | Internal Medicine | 26711 Woodward Ave Ste 307, Huntington Woods, MI 48070-1369 | 2014-12-05 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH HAVEN |
| Zip Code | 49090 |
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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.