| Organization Name: | BRADLEY C ROBERTSON MD L L C |
| NPI Number: | 1073793501 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BRADLEY CHARLES ROBERTSON (OWNER) |
| Mailing Address: | 1 Barrington Place Suite 106 Bel Air |
| State: | MD US |
| Postal Code: | 210145607 |
| Phone Number: | 4108367205 |
| Fax Number: | 4108367235 |
| NPI Enumeration Date: | 11/13/2007 |
| NPI Last Update Date: | 03/14/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2086S0122X |
| License Number: | D0037409 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MD |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Surgery |
| Taxonomy Specialization: | Plastic and Reconstructive Surgery |
| Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |