Robert Bradley Boughan, MD | |
1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1602 | |
(410) 874-1400 | |
(410) 874-1411 |
Full Name | Robert Bradley Boughan |
---|---|
Gender | Male |
Speciality | Internal Medicine |
Experience | 19 Years |
Location | 1106 Annapolis Rd, Odenton, Maryland |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770608721 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | D0069537 (Maryland) | Primary |
208000000X | Pediatrics | D0069537 (Maryland) | Secondary |
Facility Name | Location | Facility Type |
---|---|---|
Stella Maris Inc | Timonium, MD | Home health agency |
Encompass Health Home Health | Owings mills, MD | Home health agency |
University Of Md St Joseph Medical Center | Towson, MD | Hospital |
Mercy Medical Center Inc | Baltimore, MD | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Agape Physical Therapy And Sports Rehabilitation Lp | 3870741390 | 210 |
Maryland Family Care Inc | 5092629394 | 127 |
Entity Name | Maryland Family Care Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598718256 PECOS PAC ID: 5092629394 Enrollment ID: O20031119000273 |
Mailing Address | Practice Location Address |
---|---|
Robert Bradley Boughan, MD 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1602 Ph: (410) 874-1400 | Robert Bradley Boughan, MD 1106 Annapolis Rd, Suite 310, Odenton, MD 21113-1602 Ph: (410) 874-1400 |
Dr. Wanda Rivera, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1132 Annapolis Rd, Odenton, MD 21113 Phone: 410-874-1400 | |
Melissa Nedelka Anderson, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 1110 Annapolis Rd, Odenton, MD 21113 Phone: 443-351-3917 Fax: 443-351-3918 | |
Dr. Jefferson L Hendrickson, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1106 Annapolis Rd, Odenton, MD 21113 Phone: 410-874-1400 | |
Ms. Pamela Denise Ponder, Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 2603 Portola Court, Odenton, MD 21113 Phone: 301-377-6891 | |
Dr. Barry I Bercovitz, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 1106 Annapolis Rd, Odenton, MD 21113 Phone: 410-874-1400 Fax: 410-874-1411 | |
Dr. Mark H. Davino, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1106 Annapolis Rd, Suite 310, Odenton, MD 21113 Phone: 410-874-1400 Fax: 410-874-1411 |