Individual
ROBERT BRADLEY BOUGHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1734 YORK RD, LUTHERVILLE, MD 21093-5606
(410) 252-2273
Mailing address
11121 YORK RD, HUNT VALLEY, MD 21030-2006
(410) 628-0026
(410) 667-6834
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0069537
MD
208000000X
Pediatrics Physician
D0069537
MD
Other
Enumeration date
03/20/2007
Last updated
11/15/2024
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