Provider Demographics
NPI:1578631834
Name:WATKINS, BRADLEY RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:RICHARD
Last Name:WATKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:7315 WISCONSIN AVE, SUITE 700
Mailing Address - Street 2:JHCP DOWNTOWN BETHESDA, AIR RIGHT CENTER
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7315 WISCONSIN AVE, SUITE 700
Practice Address - Street 2:JHCP DOWNTOWN BETHESDA, AIR RIGHT CENTER
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:240-235-9100
Practice Address - Fax:301-656-2540
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-02
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0066181207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program