Dennis McCray Bullock, CERTIFIDE SURGICAL A

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

SA0051 Issued in DC

Practice address

1083 Fort Davis TRL
Lusby, MD 20657-3556

Phone

(410) 326-2747

NPI assigned

Nov 2, 2018

Sex

Male

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 2, 2018.

{
    "created_epoch": "1541116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1541116800000",
    "number": "1770050296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1083 FORT DAVIS TRL",
            "city": "LUSBY",
            "state": "MD",
            "postal_code": "206573556",
            "telephone_number": "443-532-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1083 FORT DAVIS TRL",
            "city": "LUSBY",
            "state": "MD",
            "postal_code": "206573556",
            "telephone_number": "410-326-2747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLOCK",
        "first_name": "DENNIS",
        "middle_name": "MCCRAY",
        "credential": "CERTIFIDE SURGICAL A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-02",
        "last_updated": "2018-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "DC",
            "license": "SA0051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Williams Bennett, M.D.
• Les A Binnix, PMHNP, LPCMH
• Felicia Bloodsaw, CERT. HAIR LOSS SPEC
• Blue Sails Counseling and Consulting, Inc
• Alexis Morgan Broom, MSW, LCSW
• Calvert County Health Department
• Calvert County Health Department
• Calvert County Health Department
• Calvert County Health Department
• Calvert Memorial Hospital of Calvert County

• All providers in Lusby, MD
• Orthopaedic Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2018; 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.