Healthcare Provider Details

I. General information

NPI: 1376687780
Provider Name (Legal Business Name): BARTHOLOMEW RADOLINSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2007
Last Update Date: 09/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6410 ROCKLEDGE DR SUITE 503
BETHESDA MD
20817-1809
US

IV. Provider business mailing address

25 CROSSROADS DRIVE SUITE 306
OWINGS MILLS MD
21117
US

V. Phone/Fax

Practice location:
  • Phone: 301-530-1700
  • Fax: 301-530-0418
Mailing address:
  • Phone: 443-738-2872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberD0067305
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: