Healthcare Provider Details

I. General information

NPI: 1104386267
Provider Name (Legal Business Name): BRADLEY GELFAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2019
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20410 OBSERVATION DR STE 102
GERMANTOWN MD
20876-6424
US

IV. Provider business mailing address

20410 OBSERVATION DR STE 102
GERMANTOWN MD
20876-6424
US

V. Phone/Fax

Practice location:
  • Phone: 202-835-2222
  • Fax: 202-969-1798
Mailing address:
  • Phone: 202-835-2222
  • Fax: 202-969-1798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberMD600004322
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License NumberD0103621
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: