| Bradley Ingram, PAC | |
|
22911 Jefferson Blvd, Smithsburg, MD 21783-1617 | |
| (301) 824-3343 | |
| (301) 824-6323 |
| Full Name | Bradley Ingram |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 25 Years |
| Location | 22911 Jefferson Blvd, Smithsburg, 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 |
|---|---|---|---|
| 1144290321 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | 0110001879 (Virginia) | Secondary |
| 363AM0700X | Physician Assistant - Medical | C0003519 (Maryland) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Meritus Medical Center Inc | 7113811795 | 730 |
| Medical Practices Of Antietam, Llc | 2567353865 | 229 |
| Entity Name | Frederick Health Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982600771 PECOS PAC ID: 0446149256 Enrollment ID: O20040311000363 |
| Entity Name | Medical Practices of Antietam, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1710854963 PECOS PAC ID: 2567353865 Enrollment ID: O20040324001019 |
| Mailing Address | Practice Location Address |
|---|---|
| Bradley Ingram, PAC 11110 Medical Campus Rd, Suite 229, Hagerstown, MD 21742-6700 Ph: (301) 665-4526 | Bradley Ingram, PAC 22911 Jefferson Blvd, Smithsburg, MD 21783-1617 Ph: (301) 824-3343 |
Taylor B James, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 22911 Jefferson Blvd, Smithsburg, MD 21783 Phone: 301-824-3343 |
Jennifer Lynn Nunnelee, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 22911 Jefferson Blvd, Smithsburg, MD 21783 Phone: 301-824-3343 Fax: 301-824-6323 |
Stephanie Maxsell, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 22911 Jefferson Blvd, Smithsburg, MD 21783 Phone: 301-824-3343 |