PENINSULA SURGICAL GROUP, P.A. (NPI# 1962484428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962484428 |
| Entity Type | Organization |
| Organization Name | PENINSULA SURGICAL GROUP, P.A. |
| Practice Address |
145 E Carroll St Salisbury MD 21801-5454 |
| Mailing Address |
Po Box 3317 Salisbury MD 21802-3317 |
| Practice Telephone | 4105482600 |
| Practice Fax Number | 4105482607 |
| Mailing Telephone | 4105482600 |
| Mailing Fax Number | 4105482607 |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2011-12-09 |
| Authorized Official Name | JOHN A BARTKOVICH (OWNER) |
| Authorized Official Telephone | 4105482600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 978541800 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811084304 | Peninsula Surgical Group, P.a. | Clinic/Center | 145 East Carroll Street, Salisbury, MD 21801-5454 | 2006-10-06 |
| Street Address |
145 E CARROLL ST |
| City | SALISBURY |
| State | MD |
| Zip Code | 21801-5454 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114925278 | Charles Philip Brenner | Dentist | 145 E Carroll St, Salisbury, MD 21801-5454 | 2005-07-13 |
| 1104453208 | Tidalhealth Primary Care, LLC | Family Medicine | 145 E Carroll St, Salisbury, MD 21801-5454 | 2020-03-26 |
| 1780011312 | Peninsula Surgical Group, Pa | Nurse Practitioner | 145 E Carroll St, Salisbury, MD 21801-5454 | 2013-09-27 |
| 1306133913 | Tejal Dharia | Family Medicine | 145 E Carroll St, Suite 101-102, Salisbury, MD 21801 | 2011-07-03 |
| 1992857247 | Charles P. Brenner, D.d.s., P.a. | Dentist | 145 E Carroll St, Salisbury, MD 21801-5454 | 2007-01-17 |
| 1134202252 | Ramesh K. Agarwal, M.d., P.a. | Specialist | 145 E Carroll St, Unit 103, Salisbury, MD 21801-5454 | 2006-10-23 |
| 1104926021 | Ramesh K Agarwal | Internal Medicine | 145 E Carroll St, Unit 103, Salisbury, MD 21801 | 2006-09-22 |
| 1992779136 | Nicole M Alu-parks | Family Medicine | 145 E Carroll St, Salisbury, MD 21801 | 2006-02-15 |
| 1295705887 | Peninsula Oncology and Hematology | Specialist | 145 E Carroll St, Suite A-1, Salisbury, MD 21801-5454 | 2006-01-25 |
| 1780668913 | Nicholas J Dudas | Surgery | 145 E Carroll St, Salisbury, MD 21801-5454 | 2005-12-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487263760 | Patricia Ann Nativio | Specialist/Technologist | University of Maryland University Eastern Shore, William P Hytche Athletic Center, Princess Anne, MD 21801 | 2020-07-23 |
| 1710516315 | Launa Duffy | Counselor | 1300 East Carroll St, Salisbury, MD 21801 | 2020-04-06 |
| 1275161960 | Zion Wellness Center | Psychiatry & Neurology | 2324 West Zion Road Unit 110, Salisbury, MD 21801 | 2020-03-30 |
| 1508404997 | Pridgett Harmon | Counselor | 2324 West Zion Road, Suite 112, Salisbury Md, MD 21801 | 2019-12-16 |
| 1821646324 | Diane Palmer | Counselor | 2324 West Zion Rd., Suit 112, Salisbury, MD 21801 | 2019-08-28 |
| 1558923672 | Oc Wellness LLC | Nurse Practitioner | 1410 S Salisbury Blvd Unit 1, Salisbury, MD 21801 | 2019-06-28 |
| 1033686670 | Megan Insley | Speech-Language Pathologist | 1213 Emeron Ave, Salisbury, MD 21801 | 2018-11-01 |
| 1811462831 | Kailyn Asbury | Registered Nurse | 100 E. Carroll St., Prmc Dept of Physical Medicine, Salisbury, MD 21801 | 2018-10-05 |
| 1750866380 | Marc Levin Mcdonald | Physical Therapist | 2420 North Salisbury Blvd Unit 5, Salisbury, MD 21801 | 2018-09-28 |
| 1891277695 | Lindsay Britt Stallings | Counselor | 116 West Main St. Suite 204, Salisbury, MD 21801 | 2018-08-29 |
| Find all providers in zip 21801 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| 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 |
|---|---|---|---|---|
| 1720366552 | Hossain Said Mahmoudian | Surgery | 6507 Deer Pointe Dr, Salisbury, MD 21804-1667 | 2011-07-27 |
| 1326331810 | Herbert Anton Steimel | Surgery | 121 Wellington Drive, Salisbury, NC 28144-8546 | 2011-05-17 |
| 1033363965 | Novant Medical Group, Inc. | Surgery | 911 W Henderson St Ste 410, Salisbury, NC 28144 | 2008-11-05 |
| 1548293962 | Walter P Lischick | Surgery | 6507 Deer Pointe Drive, Salisbury, MD 21804 | 2006-07-09 |
| 1164455580 | Douglas B Wilhite | Surgery | 6507 Deer Pointe Driver, Salisbury, MD 21804 | 2006-07-09 |
| 1891725636 | Christopher E Mciltrot Md Pa | Surgery | 103 Dorsett Dr, Suite A, Salisbury, NC 28144-2278 | 2006-07-04 |
| 1497741920 | Merle Rudy Busby | Surgery | 901 W Henderson St, Salisbury, NC 28144-2727 | 2005-09-20 |
| 1588061261 | Novant Medical Group Inc | Surgery | 530 Corporate Cir, Suite 200, Salisbury, NC 28147-8074 | 2014-11-25 |
| 1093904575 | Gavin Isaac Misner | Surgery | 911 W Henderson St, Suite 410, Salisbury, NC 28144-2736 | 2007-10-19 |
| 1215122809 | Mid Atlantic Surgical Group | Surgery | 6507 Deer Pointe Drive, Salisbury, MD 21804 | 2007-09-07 |
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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.