Organization Active NPI

Charles County Surgical Associates, LLC

  • MOHS-Micrographic Surgery Physician
  • White Plains, MD
National Provider Identifier
1003002163
Registry record updated Sep 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
CHARLES COUNTY SURGICAL ASSOCIATES, LLC
Practice address
4225 Altamont PL Unit 3
White Plains, MD 20695-3063
Phone
(301) 374-9591
NPI assigned
Sep 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robert S Berger
Title
MD
Phone
(301) 374-9591

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ND0101X Primary

Addresses

Primary practice location

4225 Altamont PL Unit 3
White Plains, MD 20695-3063

Mailing address

4225 Altamont PL Unit 3
White Plains, MD 20695-3063

National Provider Directory

National Provider Directory

Locations

4225 Altamont Pl
White Plains, MD 20695
Phone (301) 374-9591

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1003002163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4225 ALTAMONT PL UNIT 3",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4225 ALTAMONT PL UNIT 3",
            "city": "WHITE PLAINS",
            "state": "MD",
            "postal_code": "206953063",
            "telephone_number": "301-374-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES COUNTY SURGICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "301-374-9591"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.