MEDICARE: BRADFORD HARRIS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2080P0203X	Pediatric Critical Care Medicine Physician	2001-01555	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245320969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRADFORD HARRIS MD

Provider Business Mailing Address
First Line	:	1708 W ROGERS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-4545
Country	:	US
Telephone Number	:	410-578-8600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1708 W ROGERS AVE
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21209-4545
Country	:	US
Telephone Number	:	410-578-5334
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2006
Last Update Date	:	06/03/2016

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Directions to “ BRADFORD HARRIS MD” Practice Location

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