Individual
BRADLEY INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
22911 JEFFERSON BLVD, SMITHSBURG, MD 21783-1617
(301) 824-3343
(301) 824-6323
Mailing address
11110 MEDICAL CAMPUS RD, SUITE 229, HAGERSTOWN, MD 21742-6700
(301) 665-4526
(301) 665-4521
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
0110001879
VA
363AM0700X
Medical Physician Assistant
Primary
C0003519
MD
Other
Enumeration date
01/23/2006
Last updated
03/07/2023
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