MEDICARE: MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC

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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1306470687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CENTER ORTHOTICS AND PROSTHETICS, LLC

Provider Business Mailing Address
First Line	:	2421 LINDEN LN
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20910-1230
Country	:	US
Telephone Number	:	301-585-5347
Fax Number	:

Provider Business Practice Location Address
First Line	:	1531 S EDGEWOOD ST STE B
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21227-1138
Country	:	US
Telephone Number	:	410-800-4730
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	BRADFORD NEIL GARDNER
Credential	:
Telephone Number	:	615-864-8783

Provider Enumeration Date	:	02/26/2020
Last Update Date	:	03/13/2026

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