Individual
DR. BRENT BRUCE MACDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4924 CAMPBELL BLVD, SUITE 200, BALTIMORE, MD 21236-5908
(443) 442-2300
(443) 442-2330
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D47105
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
937101000
—
MD
Enumeration date
09/11/2006
Last updated
10/04/2022
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