| Doctor Name: | MR. BRADLEY RAYMOND WERNETTE |
| NPI Number: | 1063762730 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA |
| License Number: | |
| Business Practice Address: | 1375 N Main St Lapeer, MI - 484461350 |
| Business Phone Number: | 8106675869 |
| Business Fax Number: | 8106675726 |
| Mailing Address: | 514 Misty Morning Dr, FLUSHING |
| State: | MI |
| Postal Code: | 484332192 |
| Phone Number: | 8102411317 |
| Fax Number: | |
| NPI Enumeration Date: | 09/10/2012 |
| NPI Last Update Date: | 06/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AS0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Surgical |
| Taxonomy Definition: | |