NPIMap

Organization Active NPI

Mid Atlantic Skin Surgery Institute

  • Dermatology Physician
  • Waldorf, MD
National Provider Identifier
1043457468
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MID ATLANTIC SKIN SURGERY INSTITUTE
Practice address
173 Saint Patricks Dr
Suite 201
Waldorf, MD 20603-5529
Phone
(301) 475-8091
Fax
(301) 472-6712
NPI assigned
Jan 8, 2009
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Authorized official

Name
Dr. George Kannarkat Verghese, MDNPI 1629193891
Title
Medical Director
Phone
(301) 396-3401

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary
MOHS-Micrographic Surgery Physician 207ND0101X

Addresses

Primary practice location

173 Saint Patricks Dr
Suite 201
Waldorf, MD 20603-5529

Mailing address

173 Saint Patricks Dr Ste 201
Waldorf, MD 20603-5531
Phone (301) 396-3401

National Provider Directory

National Provider Directory
Tax ID family
Verghese Ling Mdpa3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

173 Saint Patricks Dr
Ste 201
Waldorf, MD 20603
Phone (301) 396-3401

Practitioners & affiliated clinicians

Practitioners 1

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": "1231372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1043457468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 SAINT PATRICKS DR STE 201",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035531",
            "telephone_number": "301-396-3401",
            "fax_number": "301-396-3403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 SAINT PATRICKS DR",
            "address_2": "SUITE 201",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206035529",
            "telephone_number": "301-475-8091",
            "fax_number": "301-472-6712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC SKIN SURGERY INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-08",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "VERGHESE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "KANNARKAT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-396-3401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.