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Organization

BRADLEY C ROBERTSON MD L L C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRADLEY CHARLES ROBERTSON M.D. (OWNER)
(410) 836-7205
Entity
Organization

Contact information

Practice address
1 BARRINGTON PLACE, SUITE 106, BEL AIR, MD 21014-5607
(410) 836-7205
(410) 836-7235
Mailing address
1 BARRINGTON PLACE, SUITE 106, BEL AIR, MD 21014-5607
(410) 836-7205
(410) 836-7235

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
D0037409
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
099N
MEDICARE
MD
01
1056903
UNITED HEALTHCARE
MD
01
2432226
CIGNA
MD
01
276BBC
CAREFIRST
MD
01
3115795
OPTIMUM CHOICE
MD
01
DC7136
RAILROAD MEDICARE
GA
01
K058 0001
CAREFIRST
DC
Enumeration date
11/13/2007
Last updated
03/14/2013
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