Provider Demographics
NPI:1558346809
Name:LERNER, BRAD DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:DOUGLAS
Last Name:LERNER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:25 CROSSROADS DR
Mailing Address - Street 2:STE 306
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117
Mailing Address - Country:US
Mailing Address - Phone:410-467-7665
Mailing Address - Fax:410-467-7746
Practice Address - Street 1:3333 N CALVERT ST
Practice Address - Street 2:SUITE 600
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2867
Practice Address - Country:US
Practice Address - Phone:410-467-7665
Practice Address - Fax:410-467-7746
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2014-04-23
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Provider Licenses
StateLicense IDTaxonomies
MDD0034608208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD091341300Medicaid
MD091341300Medicaid
E45615Medicare UPIN
MD731LO200Medicare PIN