BOSTON MEDICAL GROUP- MARYLAND, P.C. (NPI# 1083032445) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083032445 |
| Entity Type | Organization |
| Organization Name | BOSTON MEDICAL GROUP- MARYLAND, P.C. |
| Practice Address |
5500 Knoll Drive Suite 220 Columbia MD 21045 |
| Practice Telephone | 4435429241 |
| Practice Fax Number | 4435429442 |
| Mailing Telephone | 4435429241 |
| Mailing Fax Number | 4435429442 |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2014-04-02 |
| Authorized Official Name | MR. TOM L. LE (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8188082828 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| Street Address |
5500 KNOLL DRIVE SUITE 220 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497374136 | Keenan Eldridge | Behavior Technician | 8950 Md-108, Suite 100, Columbia, MD 21045 | 2020-04-13 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1417519414 | Howard County Health Department | Clinic/Center | Cradlerock Elementary School-based Wellness Center, 6700 Cradlerock Way, Columbia, MD 21045 | 2019-07-01 |
| 1649754490 | Dana Pirzchalski | Behavioral Analyst | 8815 Columbia Parkwary, 4, Columbia, MD 21045 | 2018-09-18 |
| 1871089177 | Melissa Jo Kennedy | Behavior Technician | 8815 Columbia Parkway, 4, Columbia, MD 21045 | 2018-07-10 |
| 1497246193 | Kjd | Physical Therapist | 8900 Columbia 100 Pkwy Ste C, Columbia, MD 21045 | 2018-05-29 |
| 1174010276 | Roger Lee | Audiologist | 8600 Snowden River Pkwy #309, Columbia, MD 21045 | 2018-04-16 |
| 1811497910 | Dominique Nichole Hale | Behavior Technician | 8115 Columbia 100 Parkway, Suite 4, Columbia, MD 21045 | 2018-02-15 |
| 1982116802 | Bradley D. Stiles | Acupuncturist | 6257 Deep River Cyn, Columbia, MD 21045 | 2017-11-01 |
| 1194234849 | University of Maryland Eye Associates, P.a. | Eyewear Supplier (Equipment, not the service) | 5900 Waterloo Road, Suite 230, Columbia, MD 21045 | 2017-09-26 |
| Find all providers in zip 21045 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225699408 | Garth Sherman | Urology | 1 Hospital Dr # Mc301, Columbia, MO 65201-5276 | 2019-06-27 |
| 1902326622 | Alexander Anderson | Urology | 1 Hospital Drive University of Missouri Mc404, Columbia, MO 65212-0001 | 2017-06-23 |
| 1649633736 | Jack Campbell | Urology | 3101 Belinda Ct, Columbia, MO 65203-3848 | 2016-04-05 |
| 1336567353 | Katherine Smentkowski | Urology | 10710 Charter Dr Ste 130, Columbia, MD 21044-3258 | 2014-04-07 |
| 1104087584 | Jennifer L Bepple | Urology | 10710 Charter Dr., Suite 130, Columbia, MD 21044-3128 | 2008-06-19 |
| 1740365857 | John Mark Mcmurtry | Urology | 3315 Berrywood Dr, Suite 201, Columbia, MO 65201-6571 | 2006-10-26 |
| 1962443887 | Thomas B Edmunds | Urology | 2724 Middleburg Dr, Columbia, SC 29204-2437 | 2006-06-10 |
| 1922099407 | Rex Brugh IIi | Urology | 9 Richland Medical Park, Suite 500, Columbia, SC 29203-6859 | 2005-11-02 |
| 1265433916 | Charlotte Anne Batey | Urology | 1407 Hatcher Ln, Columbia, TN 38401-3535 | 2005-08-03 |
| 1023019734 | Laurence T O'connor | Urology | 1301 Taylor St Ste 1a, Columbia, SC 29201-2946 | 2005-08-03 |
| Find all providers in COLUMBIA | ||||
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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.