MONTGOMERY DERMATOLOGY ASSOCIATES, LLC (NPI# 1083012355) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083012355 |
| Entity Type | Organization |
| Organization Name | MONTGOMERY DERMATOLOGY ASSOCIATES, LLC |
| Practice Address |
15225 Shady Grove Rd Ste. 303 Rockville MD 20850-3254 |
| Practice Telephone | 3012162980 |
| Practice Fax Number | 3012162982 |
| Mailing Telephone | 3012162980 |
| Mailing Fax Number | 3012162982 |
| Enumeration Date | 2014-12-18 |
| Last Update Date | 2014-12-18 |
| Authorized Official Name | DR. WALTER J GIBLIN (MEMBER / OWNER) |
| Authorized Official Telephone | 3012162983 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
D0042867 | MD | Ambulatory Health Care Facilities |
| Street Address |
15225 SHADY GROVE RD STE. 303 |
| City | ROCKVILLE |
| State | MD |
| Zip Code | 20850-3254 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093719023 | Alan Stuart Chanales | Internal Medicine | 15225 Shady Grove Rd, Rockville, MD 20850-3254 | 2005-06-08 |
| 1922344985 | Cancer Professionals of Greater Washington, Pllc | Internal Medicine | 15225 Shady Grove Rd, Suite 210, Rockville, MD 20850-3254 | 2012-12-19 |
| 1902127087 | Blue Door Pharmacies | Pharmacy | 15225 Shady Grove Rd, Suite 101, Rockville, MD 20850-3254 | 2010-06-12 |
| 1962739052 | Cheryl F Callahan Dds Pa | Dentist | 15225 Shady Grove Rd, Ste 301, Rockville, MD 20850 | 2009-11-10 |
| 1689826380 | Dr. Ashtar Hematology & Oncology Professional Association LLC | Internal Medicine | 15225 Shady Grove Rd, Suite 210, Rockville, MD 20850-3254 | 2008-10-14 |
| 1538317243 | Martin W. Graf M.d.,p.a. | Clinic/Center | 15225 Shady Grove Rd, Suite 203, Rockville, MD 20850-3254 | 2008-09-05 |
| 1225294259 | Veronica F. Miller | Dentist | 15225 Shady Grove Rd, Suite 301, Rockville, MD 20850-3254 | 2008-07-30 |
| 1942466990 | Seong E Ko | Nurse Practitioner | 15225 Shady Grove Rd, Suite 103, Rockville, MD 20850-3254 | 2008-07-30 |
| 1861656670 | Alexander Sebastiaan Asser | Internal Medicine | 15225 Shady Grove Rd, Suite 201, Rockville, MD 20850-3254 | 2008-07-11 |
| 1922268259 | Rebecca Elizabeth Elias-bachrach | Pediatrics | 15225 Shady Grove Rd, Suite 304, Rockville, MD 20850-3254 | 2008-06-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487286050 | Um Fdsp Associates, P.a. | Dentist | 9631 Gudelsky Drive, Suite 2135, Rockville, MD 20850 | 2020-02-11 |
| 1134767874 | Bh Brightview Fallsgrove Opco, LLC | Alzheimer Center (Dementia Center) | 9200 Darnestown Road, Rockville, MD 20850 | 2019-12-12 |
| 1750924205 | Omer N Pamuk | Internal Medicine | 9000 Rockville Pike, Building 10, Room 10n-311, Rockville, MD 20850 | 2019-10-28 |
| 1902456502 | Fousseyni M Diawara | Radiologic Technologist | 1680 E Gude Dr Ste 302, Rockville, MD 20850 | 2019-09-16 |
| 1104485697 | Barbara S Delsack | Speech-Language Pathologist | Montgomery County Public Schools, 850 Hungerford Drive, Rockville, MD 20850 | 2019-06-10 |
| 1982178158 | Larissa Woloszyn | Behavioral Analyst | 15425 Shady Grove, Suite 320, Rockville, MD 20850 | 2019-01-21 |
| 1417421843 | Wei Li | Acupuncturist | 9600 Blackwell Road. Suite 300, Rockville, MD 20850 | 2019-01-18 |
| 1881168805 | Heather Jean Scurtu Mann | Psychologist | Quince Orchard Psychotherapy, 9707 Key West Avenue, Suite 100, Rockville, MD 20850 | 2019-01-12 |
| 1295208486 | Laura Hanley | Physical Therapy Assistant | The Village At Rockville, Functional Pathways, 9701 Veirs Drive, Rockville, MD 20850 | 2019-01-10 |
| 1538641964 | Shamire Pierre-louis | Speech-Language Pathologist | 2 Research Place, Rockville, MD 20850 | 2018-09-01 |
| Find all providers in zip 20850 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285872762 | Pediatric Gastroenterology of Greater Washington | Clinic/Center | 2264 Glenmore Ter, Rockville, MD 20850-3051 | 2009-01-22 |
| 1821393455 | Robert B Karp, Md, Pa | Clinic/Center | 11119 Rockville Pike, Suite G100, Rockville, MD 20852-3143 | 2011-01-12 |
| 1285967091 | James Yan, Md Pa | Clinic/Center | 11119 Rockville Pike, #320, Rockville, MD 20852-3143 | 2009-09-10 |
| 1134361439 | Sanford N. Richman, Md, Chartered | Clinic/Center | 11500 Old Georgetown Rd, Rockville, MD 20852-2735 | 2009-04-01 |
| 1083869556 | A. Jerry Friedman, M.d., P.a. | Clinic/Center | 9715 Medical Center Dr, Suite 531, Rockville, MD 20850-3320 | 2008-11-24 |
| 1265688915 | Cedar Lane Medical Center, LLC | Clinic/Center | 11119 Rockville Pike, Suite 316, Rockville, MD 20852-3143 | 2008-08-13 |
| 1770537219 | Century Medicine Inc. | Clinic/Center | 932 Hungerford Dr, 11 A, Rockville, MD 20850-1713 | 2006-05-20 |
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|---|---|---|---|---|
| 1689295511 | Potomac Medical Aesthetics, LLC | Clinic/Center | 7811 Montrose Rd Ste 310, Potomac, MD 20854-3330 | 2020-05-01 |
| 1215576079 | Alexander Heilner | Clinic/Center | 614 Hollen Rd, Baltimore, MD 21212-2715 | 2019-12-27 |
| 1184288003 | Mjd Chiropractic LLC | Clinic/Center | 6666 Security Blvd Ste 4, Baltimore, MD 21207-4025 | 2019-04-25 |
| 1104383975 | Alpha Gi Care, PC | Clinic/Center | 7247 Hanover Pkwy Ste A, Greenbelt, MD 20770-3661 | 2019-02-27 |
| 1417430117 | Emily Clarke-pearson, Md, PC | Clinic/Center | 949 Fell St Ste B, Baltimore, MD 21231-3505 | 2018-09-10 |
| 1437651742 | Total You Integrative Healthcare Inc | Clinic/Center | 9135 Piscataway Rd Ste 410, Clinton, MD 20735 | 2018-03-02 |
| 1063958213 | Medsultants | Clinic/Center | 10317 Kingsway Ct, Ellicott City, MD 21042-5802 | 2017-01-12 |
| 1124564703 | Fall Prevention and Stroke Rehab Physician, LLC | Clinic/Center | 2701 Jeremy Ct Apt E, Baltimore, MD 21209-3062 | 2017-01-06 |
| 1851747885 | Kempannasudhakar,md,pc | Clinic/Center | 7610 Carroll Ave Ste 230, Takoma Park, MD 20912-6312 | 2016-05-09 |
| 1891159661 | Wellave, LLC | Clinic/Center | 411 Aviation Way Ste 245, Frederick, MD 21701 | 2016-04-07 |
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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.