Provider Demographics
NPI:1942603360
Name:SCHWIMMER, BRADLEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:
Last Name:SCHWIMMER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1708 W ROGERS AVE
Mailing Address - Street 2:ATTN: BRADLEY SCHWIMMER - PSYCHOLOGY
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-4545
Mailing Address - Country:US
Mailing Address - Phone:410-578-5081
Mailing Address - Fax:410-367-4197
Practice Address - Street 1:1708 W ROGERS AVE
Practice Address - Street 2:ATTN: BRADLEY SCHWIMMER - PSYCHOLOGY
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-4545
Practice Address - Country:US
Practice Address - Phone:410-578-5081
Practice Address - Fax:410-367-4197
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05462103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical