Healthcare Provider Details

I. General information

NPI: 1710075494
Provider Name (Legal Business Name): BERNARD BIGLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80650 VAN DYKE RD
BRUCE MI
48065-1333
US

IV. Provider business mailing address

80650 VAN DYKE RD
BRUCE MI
48065-1333
US

V. Phone/Fax

Practice location:
  • Phone: 810-798-6410
  • Fax:
Mailing address:
  • Phone: 810-798-6410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number4301023725
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: