- Practice location
- 30575 Woodward Ave, Royal Oak, MI 48073-0980
- Phone
- 248-280-8550
- Fax
- 844-266-0093
- Last updated
- May 19, 2026
Nicole Bradway is a Physician Assistant based in Royal Oak, MI. Nicole Bradway practices in Royal Oak, MI. The NPI Number for Nicole Bradway is 1639698236 and holds a License No. 5601010351 (MI). The current practice location address for Nicole Bradway is 30575 Woodward Ave, Royal Oak, MI 48073-0980 and can be reached out via phone at 248-280-8550 and via fax at 844-266-0093.
Provider Profile Details
- NPI Number
- 1639698236
- Provider Name
- Nicole Bradway
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 30575 Woodward Ave, Royal Oak, MI 48073-0980
- Phone Number
- 248-280-8550
- Fax Number
- 844-266-0093
- Primary Taxonomy
- Physician Assistant · 363A00000X
- Sole Proprietor
- Yes
- Other Names
- Nicole Shelly, PA-C (Former Name)
- Provider Enumeration Date
- September 14, 2017
- Last Update Date
- May 19, 2026
- Certification Date
- May 19, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 30575 Woodward Ave
Royal Oak, MI 48073-0980 - City
- Royal Oak
- State
- Michigan
- Zip
- 48073-0980
- Phone Number
- 248-280-8550
- Fax Number
- 844-266-0093
Provider Business Mailing Address Details
- Address
- Po Box 18998
Belfast, ME 04915-4084 - City
- Belfast
- State
- ME
- Zip
- 04915-4084
- Phone Number
- 469-803-3000
License Information
- Taxonomy (1)
- Physician Assistant, Surgical · 363AS0400X
- License Number (2)
- 5601010351
- License State (2)
- MI
- Taxonomy (2)
- Physician Assistant · 363A00000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Physician Assistants near Royal Oak, MI
View all Physician Assistants in Royal Oak →Frequently Asked Questions
What is the NPI number of Nicole Bradway?
The NPI number of Nicole Bradway is 1639698236. It was assigned on September 14, 2017 and is currently active in the NPPES registry.
What is the specialty of Nicole Bradway?
Nicole Bradway is registered under the primary taxonomy Physician Assistant (code 363A00000X), licensed in MI under license number 5601010351.
Where does Nicole Bradway practice?
The practice location is 30575 Woodward Ave, Royal Oak, MI 48073-0980. The office can be reached at 248-280-8550 (phone) or 844-266-0093 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1639698236 directly on the NPPES registry website.