Provider Demographics
NPI:1295799252
Name:BRIDGES, JAMES D (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:BRIDGES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 418837
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-8837
Mailing Address - Country:US
Mailing Address - Phone:888-846-5527
Mailing Address - Fax:607-324-2369
Practice Address - Street 1:9905 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-6533
Practice Address - Country:US
Practice Address - Phone:301-309-6765
Practice Address - Fax:301-309-2230
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00384472085R0001X
VA01010486502085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD497785OtherNCPPO
MD920004783OtherRAILROAD MEDICARE
MD8114726001OtherCIGNA
MD00002153845 02OtherUNITED HEALTHCARE
MD220586OtherMAMSI
MD5481704OtherAETNA PPO/POS
MD1728487OtherFIRST HEALTH/CCN
MD4583OtherELDER HEALTH
MD60332701OtherCAREFIRST BC/BS
MD68166OtherAMERIGROUP
MD275275702OtherAETNA HMO
DC29020003OtherCAREFIRST BC/BS
MD38215OtherJOHNS HOPKINS HEALTHCARE
MD469731OtherPHCS
MD1728487OtherFIRST HEALTH/CCN
MD469731OtherPHCS
920004788Medicare PIN