Healthcare Provider Details

I. General information

NPI: 1396303848
Provider Name (Legal Business Name): BRADLEY PHILIP PERRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 MEDICAL PKWY
ANNAPOLIS MD
21401-3773
US

IV. Provider business mailing address

2001 MEDICAL PKWY BELCHER PAVILION STE# 606
ANNAPOLIS MD
21401-3773
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-1000
  • Fax:
Mailing address:
  • Phone: 248-462-0285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberD0106178
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberD0106178
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: