Provider Demographics
NPI:1497703581
Name:HUNTER, BRADLEY J (DO)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:J
Last Name:HUNTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:19735 GERMANTOWN ROAD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874
Mailing Address - Country:US
Mailing Address - Phone:301-917-6513
Mailing Address - Fax:301-917-6506
Practice Address - Street 1:10215 FERNWOOD ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817
Practice Address - Country:US
Practice Address - Phone:301-493-4440
Practice Address - Fax:301-493-9778
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2010-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDH0058874207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H66180Medicare UPIN
MDH66180Medicare UPIN
DC009799P45Medicare ID - Type Unspecified