University of Maryland Community Medical Group, Inc.

Organization Active NPI Family Medicine Physician · La Plata, MD

NPI 1003661372 · NPPES record last updated Apr 20, 2024

Key facts

NPI
1003661372
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
Practice address
5 North la Plata Court
Suite 202
La Plata, MD 20646-5208
Phone
(301) 609-4276
NPI assigned
Apr 20, 2024
Organization subpart
No

Authorized official

Name
Paul Stephen Nicholson
Title
Ao
Phone
(410) 337-1602

Corporate family (same tax ID) 12

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

Practitioners 4

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

National Provider Directory

Tax ID family
University of Maryland Community Medical Group Inc (171 organizations share this tax ID)

Locations

5 N La Plata Ct
Ste 202
La Plata, MD 20646
Phone (301) 609-4276

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

5 North la Plata Court
Suite 202
La Plata, MD 20646-5208

Mailing address

900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924

Other providers in La Plata, MD

All providers in La Plata, MD · Family Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.