Boston Medical Group- Maryland, P.C.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

BOSTON MEDICAL GROUP- MARYLAND, P.C.

Practice address

5500 Knoll Drive
Suite 220
Columbia, MD 21045

Phone

(443) 542-9241

Fax

(443) 542-9442

NPI assigned

Apr 2, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Tom L. Le, M.D.

Title

Medical Director

Phone

(818) 808-2828

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1396396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1396396800000",
    "number": "1083032445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 KNOLL DRIVE",
            "address_2": "SUITE 220",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21045",
            "telephone_number": "443-542-9241",
            "fax_number": "443-542-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL DRIVE",
            "address_2": "SUITE 220",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21045",
            "telephone_number": "443-542-9241",
            "fax_number": "443-542-9442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON MEDICAL GROUP- MARYLAND, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-02",
        "last_updated": "2014-04-02",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-808-2828",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isatu S Borbor
• Ma Cara Borja
• Donna Borntrager, RN, BSN
• Bernard Bossman
• Wilbert Bostic Jr.
• Tammi M Boswell, NP
• Jainine Botek, RPH
• Bobbi Hitchcock Boteler, R.D.
• Ellen Florence Boudreau, M.D.
• Elana Patrice Bouldin, LCSW-C

• Urology Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Urology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2014; 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.