Healthcare Provider Details

I. General information

NPI: 1871337857
Provider Name (Legal Business Name): FELIX BRATOSIN MBBS, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2024
Last Update Date: 11/05/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

COREWELL HEALTH WEST ID CLINIC 230 MICHIGAN STREET, SUITE 230
GRAND RAPIDS MI
49503
US

IV. Provider business mailing address

DRAGALINA 41-4 300166
TIMISOARA TIMIS
300166
RO

V. Phone/Fax

Practice location:
  • Phone: 616-774-2822
  • Fax: 616-391-8665
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: