Healthcare Provider Details

I. General information

NPI: 1932561172
Provider Name (Legal Business Name): MICHAEL UNDERWOOD BRADY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2016
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 W JOPPA RD STE 210
TIMONIUM MD
21093-4664
US

IV. Provider business mailing address

2360 W JOPPA RD STE 210
TIMONIUM MD
21093-4664
US

V. Phone/Fax

Practice location:
  • Phone: 410-583-2890
  • Fax:
Mailing address:
  • Phone: 410-583-2890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License NumberD0084492
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberD0084492
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: