MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC (NPI# 1063880599) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063880599 |
| Entity Type | Organization |
| Organization Name | MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC |
| Other Organization Name | MEDSTAR SOUTHERN MARYLAND VASCULAR AND GENERAL SURGERY |
| Practice Address |
7501 Surratts Rd Suite 208 Clinton MD 20735-3362 |
| Practice Telephone | 3018777353 |
| Practice Fax Number | 3018775637 |
| Mailing Telephone | 3018777353 |
| Mailing Fax Number | 3018775637 |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |
| Authorized Official Name | JANE E RAYMOND (ASSOCIATE VP) |
| Authorized Official Telephone | 3018563019 |
| Is Organization Subpart | Y |
| Parent Organization Name | MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MedStar Southern Maryland Vascular and General Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982753877 | Medstar Southern Maryland Physicians, LLC | Pediatrics | 10 Saint Patricks Drive, Suite 105, Waldorf, MD 20603-4519 | 2007-01-09 |
| 1780629683 | Medstar Southern Maryland Physicians, LLC | Family Medicine | 10 St Patricks Drive, Suite 203, Waldorf, MD 20603-4527 | 2006-06-17 |
| 1427093343 | Medstar Southern Maryland Physicians, LLC | Family Medicine | 6409 South Crain Highway, Route 301, Upper Marlboro, MD 20772 | 2006-06-17 |
| 1174568091 | Medstar Southern Maryland Physicians, LLC | Family Medicine | 900 East Swan Creek Road, Fort Washington, MD 20744 | 2006-06-17 |
| 1801837786 | Medstar Southern Maryland Physicians, LLC | Internal Medicine | 10403 Hospital Drive, Suite 103, Clinton, MD 20735-3134 | 2006-06-09 |
| 1316340201 | Medstar Southern Maryland Physicians, LLC | Obstetrics & Gynecology | 11340 Pembrooke Sq, Suite 203, Waldorf, MD 20603-4808 | 2014-10-06 |
| 1871903054 | Medstar Southern Maryland Physicians, LLC | Surgery | 7501 Surratts Rd, Suite 305, Clinton, MD 20735-3362 | 2014-04-28 |
| 1720322134 | Medstar Southern Maryland Physicians, LLC | Internal Medicine | 10 Saint Patricks Dr, Suite 203, Waldorf, MD 20603-4527 | 2012-11-26 |
| 1184977142 | Medstar Southern Maryland Physicians, LLC | Anesthesiology | 7503 Surratts Rd, Clinton, MD 20735-3358 | 2012-10-16 |
| 1992057483 | Medstar Southern Maryland Physicians, LLC | Anesthesiology | 7503 Surratts Rd, Clinton, MD 20735-3358 | 2012-10-08 |
| Street Address |
7501 SURRATTS RD SUITE 208 |
| City | CLINTON |
| State | MD |
| Zip Code | 20735-3362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154326312 | Arnaldo A. Garro | Specialist | 7501 Surratts Rd, Ste 110, Clinton, MD 20735-3350 | 2005-06-15 |
| 1386022028 | Capital Orthopaedic Specialists LLC | Durable Medical Equipment & Medical Supplies | 7501 Surratts Rd, Suite 110, Clinton, MD 20735-3362 | 2015-05-14 |
| 1902284623 | Captial Orthopaedic Specialists LLC | Physical Therapist | 7501 Surratts Rd, Suite 301, Clinton, MD 20735-3362 | 2015-05-14 |
| 1700284288 | Celia Elise Hearren | Nurse Practitioner | 7501 Surratts Rd, Suite 303, Clinton, MD 20735-3362 | 2014-12-15 |
| 1295144202 | Rhonda B Fowler | Physical Therapist | 7501 Surratts Rd, 301, Clinton, MD 20735-3362 | 2014-08-05 |
| 1871905307 | Michelle Urquhart Osborne | Nurse Practitioner | 7501 Surratts Rd, Suite 303, Clinton, MD 20735-3362 | 2014-06-02 |
| 1871903054 | Medstar Southern Maryland Physicians, LLC | Surgery | 7501 Surratts Rd, Suite 305, Clinton, MD 20735-3362 | 2014-04-28 |
| 1508293176 | John C. Patterson, M.d. | Clinic/Center | 7501 Surratts Rd, Suite 201-a, Clinton, MD 20735-3362 | 2013-09-27 |
| 1306288964 | Center for Pain Management LLC | Pain Medicine | 7501 Surratts Rd, Suite 202, Clinton, MD 20735-3362 | 2013-07-24 |
| 1336589431 | Capital Orthopaedic Specialists LLC | Dietitian, Registered | 7501 Surratts Rd, Ste 110, Clinton, MD 20735-3362 | 2013-07-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940456 | Elise Olson | Occupational Therapist | 9135 Piscataway Rd, Suite 305, Clinton, MD 20735 | 2019-03-12 |
| 1437651742 | Total You Integrative Healthcare Inc | Clinic/Center | 9135 Piscataway Rd Ste 410, Clinton, MD 20735 | 2018-03-02 |
| 1386193233 | Benedicta C Osamor | Home Health Aide | 6808 Purple Lilac Ln, Clinton, MD 20735 | 2016-10-03 |
| 1669926309 | Frankline Ngozi Obi I | Home Health Aide | 8111 Highland Meadows Dr, Clinton, MD 20735 | 2016-08-11 |
| 1770952459 | Adventures One, Inc. | Clinic/Center | 7121 Old Alexandria Ferry Rd., Clinton, MD 20735 | 2015-09-23 |
| 1730574831 | Lindsey Degeorge | Emergency Medicine | 7503 Surratts Rd Dept Of, Clinton, MD 20735 | 2015-04-06 |
| 1316341860 | Margaret Laurence-whitlock | Speech-Language Pathologist | 5807 Terence Dr., Laurence Learning Center, Clinton, MD 20735 | 2014-10-13 |
| 1699103622 | Dcps | Social Worker | 5504 Trout Run Rd, Clinton, MD 20735 | 2013-10-30 |
| 1902232614 | Rafael Antonio Acosta | Dentist | 7905 Malcolm Rd Ste 300, Clinton, MD 20735 | 2013-09-25 |
| 1407135874 | Richelle Wilson Harvey | Occupational Therapist | 8202 Shackelford Way, Clinton, MD 20735 | 2011-08-16 |
| Find all providers in zip 20735 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316227150 | Joshua Dearing | Surgery | 7503 Surratts Rd Ste 208, Clinton, MD 20735-3358 | 2011-08-25 |
| 1457307431 | Bedford F Boylston | Surgery | 7501 Surratts Rd, Suite 303, Clinton, MD 20735-3362 | 2006-05-25 |
| 1023005915 | Robert Knox | Surgery | 7501 Surratts Rd, Suite 303, Clinton, MD 20735-3362 | 2005-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326678731 | Nova Vascular Specialists, LLC | Surgery | 1952 Pulaski Hwy Ste B-2, Edgewood, MD 21040-1658 | 2020-01-24 |
| 1033683339 | Vein and Vascular Institute of Central Maryland | Surgery | 1300 York Rd Ste 200, Lutherville, MD 21093-6090 | 2019-01-20 |
| 1932651312 | Elham Oumer | Surgery | 8730 Cherry Ln Ste 10, Laurel, MD 20707-6212 | 2016-11-01 |
| 1255742961 | Marta Vismer | Surgery | 19942 Gateshead Cir, Germantown, MD 20876-6311 | 2014-05-15 |
| 1023448305 | Samer Saiedy Md Gb LLC | Surgery | 1811 Crain Hwy S, Glen Burnie, MD 21061-5561 | 2013-11-22 |
| 1285077289 | Lucy Kupersmith | Surgery | 2002 Medical Pkwy Ste 502, Annapolis, MD 21401 | 2013-04-10 |
| 1861782492 | Norman Anthony Odyniec | Surgery | 9208 Levelle Dr, Chevy Chase, MD 20815-5604 | 2011-04-16 |
| 1730480872 | James F Mcguckin Md of Md Pa | Surgery | 3450 Old Washington Rd Ste 202, Waldorf, MD 20602-3250 | 2010-11-05 |
| 1194952796 | James M Salander, Md Pa | Surgery | 11119 Rockville Pile, #204, Rockville, MD 20852 | 2009-06-22 |
| 1275783292 | William Herman Rogers | Surgery | 38 Arundel Rd, Annapolis, MD 21401-1206 | 2008-09-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.