Organization Active NPI

Samuel G. Maller M.D., P.C.

  • Family Medicine Physician
  • Silver Spring, MD
National Provider Identifier
1073639118
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0050612 Issued in MD
Legal business name
SAMUEL G. MALLER M.D., P.C.
Practice address
3305 N Leisure World Blvd
Silver Spring, MD 20906-1367
Phone
(301) 598-1590
Fax
(301) 598-1569
NPI assigned
Mar 21, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Samuel Maller, M.D.
Title
President
Phone
(301) 675-6589

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X D0050612 MD Primary

Addresses

Primary practice location

3305 N Leisure World Blvd
Silver Spring, MD 20906-1367

Mailing address

PO Box 709
Olney, MD 20830-0709

Other names 1

  • Odenton Family Medicine Other name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073639118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 709",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208300709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 N LEISURE WORLD BLVD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061367",
            "telephone_number": "301-598-1590",
            "fax_number": "301-598-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMUEL G. MALLER M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MALLER",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-675-6589",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0050612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Odenton Family Medicine",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.