Healthcare Provider Details

I. General information

NPI: 1912184870
Provider Name (Legal Business Name): BRIDGET K MCARDLE D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2008
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 15 MILE RD
STERLING HEIGHTS MI
48310-5353
US

IV. Provider business mailing address

3500 15 MILE RD
STERLING HEIGHTS MI
48310-5353
US

V. Phone/Fax

Practice location:
  • Phone: 586-977-6356
  • Fax:
Mailing address:
  • Phone: 586-977-6356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number5101016453
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: