Most Relevant Information
Provider Data
| NPI Number: | 1003015314 |
| Provider Name: | MICHELLE RENAE BRADLEY DO |
| Entity Type: | Individual |
| Taxonomy Code: | 207Q00000X |
| Specialty: | Family Medicine |
| License Number: | 52168 |
Most Important Dates
| Enumeration Date: | 07/16/2007 |
| Last Updated: | 07/21/2022 |
Provider Practice Location
4110 51ST AVE S
FARGO
ND
581047776
Practice Location Phone/Fax
| Phone: | 7013643100 |
| Fax: |
Provider Mailing Location
1702 SOUTH UNIVERSITY DRIVE
FARGO
ND
581034940
Provider Mailing Phone/Fax
| Phone: | 7013643100 |
| Fax: | 3202020756 |
Suggested EMR
Family Practice EMR