University of Maryland Community Medical Group, Inc.
Organization Active NPI Family Medicine Physician · Queenstown, MD
NPI 1104676170 · NPPES record last updated Mar 25, 2024
Key facts
- NPI
- 1104676170
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
- Practice address
- 125 Shoreway Dr Ste 210
Queenstown, MD 21658-1682 - Phone
- (410) 820-0560
- NPI assigned
- Mar 25, 2024
- Organization subpart
- No
Authorized official
- Name
- Paul Stephen Nicholson
- Title
- Ao
- Phone
- (410) 337-1602
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- University of Maryland Community Medical Group Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
125 Shoreway Dr Ste 210
Queenstown, MD 21658-1682
Mailing address
900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924
Other providers in Queenstown, MD
- Shore Health System, Inc
- Shore Orthopedics, Inc
- Shore Therapy & Wellness
- Total Renal Care Inc
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
All providers in Queenstown, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.