Bradford, Mark

Bradford, Mark is an individual health care provider with primary practice located at 1 Texas Station Ct , Timonium MD 21093-8286. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Bradford, Mark can be contacted via phone (410) 683-2120.

Contact Information

Primary practice address
1 Texas Station Ct Timonium MD 21093-8286
Phone: (410) 683-2120
Fax: (410) 683-2130
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X C0003213 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X C0003213 Maryland
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X COOO3213 Maryland

Profile Details

NPI number 1831137611
LBN Legal business name Bradford, Mark
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2006
Last updated Feb 17th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831137611 NPPES
Maryland Other 665L MEDICARE GROUP UMOA
Maryland Other 1831137611 MEDICARE GROUP UMOA

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