Bradley C Robertson MD L L C

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

D0037409 Issued in MD

Legal business name

BRADLEY C ROBERTSON MD L L C

Practice address

1 Barrington Place
Suite 106
Bel Air, MD 21014-5607

Phone

(410) 836-7205

Fax

(410) 836-7235

NPI assigned

Nov 13, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bradley Charles Robertson, M.D.

Title

Owner

Phone

(410) 836-7205

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1073793501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BARRINGTON PLACE",
            "address_2": "SUITE 106",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210145607",
            "telephone_number": "410-836-7205",
            "fax_number": "410-836-7235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BARRINGTON PLACE",
            "address_2": "SUITE 106",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210145607",
            "telephone_number": "410-836-7205",
            "fax_number": "410-836-7235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY C ROBERTSON MD L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-13",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-836-7205",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MD",
            "license": "D0037409",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "K058 0001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1056903",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "276BBC",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC7136",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "099N",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2432226",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM CHOICE",
            "identifier": "3115795",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Elizabeth Botteon, LGPC
• Meghan Bowser, NP
• Samantha Nicole Boyce, PT, DPT
• Jeanne Boyer, CRNP
• Jessica Beierle Boyer, MD
• Heidi Elizabeth Brady, RD. LD
• Brain & Spine Specialists PA
• Matthew Braswell, LCADC
• Mary-Claire A Brett, M.S. LCADC
• David C Brick, M.D.

• Plastic and Reconstructive Surgery Physician in Bel Air, MD
• Providers in Bel Air, MD by specialty
• Plastic and Reconstructive Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.