Individual
ROOSEVELT BRANDLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1310 SOUTHERN AVE SE, WASHINGTON, DC 20032-4699
(202) 574-6000
Mailing address
6913 PERRYWOOD RD, MARLBORO, MD 20772-6303
(240) 350-7684
(301) 599-1879
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M17522
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02604660
—
DC
01
—
CS8904716
CDS
DC
Enumeration date
05/10/2006
Last updated
03/07/2023
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