Healthcare Provider Details

I. General information

NPI: 1639229313
Provider Name (Legal Business Name): JENNIFER ELLEN BRADY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER ELLEN ZIMMER M.D.

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 12/04/2024
Certification Date: 12/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N WOLFE ST
BALTIMORE MD
21287-0005
US

IV. Provider business mailing address

6201 GREENLEIGH AVE FL 2
BALTIMORE MD
21220-2004
US

V. Phone/Fax

Practice location:
  • Phone: 410-955-9441
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberD0065204
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD035326
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberD0065204
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: