NPIMap

Organization Active NPI

Medstar Medical Group - Southern Maryland LLC

Doing business as MedStar Shah Medical Group LLC

  • Cardiovascular Disease Physician
  • Clinton, MD
National Provider Identifier
1003613043
Registry record updated Aug 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
Doing business as
MedStar Shah Medical Group LLC
Practice address
9131 Piscataway Rd Ste 610
Clinton, MD 20735-2568
Phone
(301) 868-2106
Fax
(301) 868-6757
NPI assigned
Feb 27, 2025
Last updated
Aug 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2025

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

Authorized official

Name
Alan Adair Buster
Title
Credentialing
Phone
(301) 373-7905

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X NU

Addresses

Primary practice location

9131 Piscataway Rd Ste 610
Clinton, MD 20735-2568

Mailing address

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-7900

Other names 1

  • MedStar Shah Medical Group LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medstar Medical Group30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754006400000",
    "number": "1003613043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206364871",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9131 PISCATAWAY RD STE 610",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207352568",
            "telephone_number": "301-868-2106",
            "fax_number": "301-868-6757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-08-01",
        "certification_date": "2025-08-01",
        "status": "A",
        "authorized_official_last_name": "BUSTER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "ADAIR",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "301-373-7905"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2081P2900X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedStar Shah Medical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MedStar Shah Medical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2025; 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.