MEDSTAR MEDICAL GROUP, LLC (NPI# 1346514817) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346514817 |
| Entity Type | Organization |
| Organization Name | MEDSTAR MEDICAL GROUP, LLC |
| Practice Address |
1406 Crain Highway Suite 106 Glen Burnie MD 21061-4058 |
| Mailing Address |
8094 Sandpiper Cir Suite O Baltimore MD 21236-4907 |
| Practice Telephone | 4107686440 |
| Mailing Telephone | 4109333017 |
| Mailing Fax Number | 4109333019 |
| Enumeration Date | 2012-03-01 |
| Last Update Date | 2012-03-01 |
| Authorized Official Name | EDWARD MILLER (VICE PRESIDENT) |
| Authorized Official Telephone | 4437258719 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255608139 | Medstar Medical Group, LLC | Internal Medicine | 2021 K St Nw, Suite 310, Washington, DC 20006-1003 | 2011-11-21 |
| Street Address |
1406 CRAIN HIGHWAY SUITE 106 |
| City | GLEN BURNIE |
| State | MD |
| Zip Code | 21061-4058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255814422 | Lotus Behavioral Health and Rehabilitation Services Inc. | Behavior Technician | 6426 Harrison Square, Glen Burnie, MD 21061 | 2018-09-12 |
| 1942795315 | Tina Brown | Behavior Technician | Rise for Autism, 510 Mccormick Drive, Ste. U-w, Glen Burnie, MD 21061 | 2018-06-27 |
| 1205351905 | Digna Emerita Sanchez De Vasquez | Specialist/Technologist, Other | 201 Fernglen Ave, Glen Burnie, MD 21061 | 2017-08-03 |
| 1255780300 | Rachel Cutts | Physical Therapist | 7711 Quarterfield Rd Ste C2, Glen Burnie, MD 21061 | 2016-06-09 |
| 1295181170 | Gaudenzia, Inc. | Counselor | 5 Crain Highway North - Rear Suite Entrance, Glen Burnie, MD 21061 | 2016-05-10 |
| 1023499548 | Mary Bourbon | Nurse Practitioner | 1600 S. Cain Highway, Suite 401, Glen Burnie, MD 21061 | 2015-06-10 |
| 1972997724 | Robert Oladeinde | Physician Assistant | 6934 Aviation Blvd Suite B, Glen Burnie, MD 21061 | 2015-03-18 |
| 1205248069 | Cathy Qing He | Anesthesiology | 1600 Crain Hwy S Ste 301, Glen Burnie, MD 21061 | 2014-05-28 |
| 1477974764 | Shannon Holder | Nurse Practitioner | 1916 Crain Hwy S Ste 2, Glen Burnie, MD 21061 | 2014-01-03 |
| 1629404207 | Marla Ann Muha | Physician Assistant | 301 Hospital Dr # 803, Glen Burnie, MD 21061 | 2013-09-16 |
| Find all providers in zip 21061 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396088415 | Ramya T Fischer | Internal Medicine | 808 Landmark Dr Ste 128, Glen Burnie, MD 21061-4983 | 2013-03-27 |
| 1144576893 | Juliet Chikaodili Azie | Internal Medicine | 301 Hospital Drive: Inpatient Team, Baltimore Washington Medical Center, Glen Burnie, MD 21061 | 2012-07-31 |
| 1972737849 | Rasha Salah Hamouda | Internal Medicine | 103 S Charter Rd Apt F, Glen Burnie, MD 21061-3161 | 2009-05-07 |
| 1366507857 | Jacob E Teitelbaum | Internal Medicine | 7 Benmere Rd, Glen Burnie, MD 21060-7235 | 2006-12-26 |
| 1235297201 | Ana Maria Martinez | Internal Medicine | 7942 Roxbury Dr, Glen Burnie, MD 21061-6247 | 2006-12-04 |
| 1801985122 | Marguerite G Summers | Internal Medicine | 7010 Ritchie Hwy, Glen Burnie, MD 21061-2902 | 2006-10-12 |
| 1588775902 | Reshma Modi | Internal Medicine | 6934 Aviation Boulevard, Suite B, Glen Burnie, MD 21061 | 2006-08-31 |
| 1649205238 | Sukhpal I Jassi | Internal Medicine | 325 Hospital Dr Ste 205, Glen Burnie, MD 21061 | 2006-07-11 |
| 1578597282 | Mark M Kim | Internal Medicine | 7927 Ritchie Hwy., Glen Burnie, MD 21061 | 2006-07-10 |
| 1619900149 | Hirut Abebe Gebrewold | Internal Medicine | 109 Governors Ct, #g, Glen Burnie, MD 21061-1867 | 2006-07-08 |
| Find all providers in GLEN BURNIE | ||||
| City | GLEN BURNIE |
| Zip Code | 21061 |
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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.