Bradford J Woelke, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301041120 Issued in MI

Practice address

6620 Highland Rd
Suite 101
Waterford, MI 48327

Phone

(248) 666-9332

Fax

(248) 666-0340

NPI assigned

Aug 19, 2005

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232496000000",
    "number": "1871585307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6620 HIGHLAND RD",
            "address_2": "SUITE 101",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "48327",
            "telephone_number": "248-666-9332",
            "fax_number": "248-666-0340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6620 HIGHLAND RD",
            "address_2": "SUITE 101",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "48327",
            "telephone_number": "248-666-9332",
            "fax_number": "248-666-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOELKE",
        "first_name": "BRADFORD",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2009-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301041120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1788924",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly Winowiecki, ATC, LAT
• Stephanie Wiseman
• Carmen Sue Wisniewski
• Kimberly Wisser
• Nancy Woehlke, MA
• Iryna Wolberg, DNP
• Kristin A Wolf, B.S., M.A.
• Mary Ann Wolfe
• Woodward Detroit CVS, L.L.C.
• Woodward Detroit CVS, L.L.C.

• Family Medicine Physician in Waterford, MI
• Providers in Waterford, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.