Clarksburg Med Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

CLARKSBURG MED INC

Doing business as

Clarksburg Medical Center

Practice address

23208 Brewers Tavern Way
Clarksburg, MD 20871-4391

Phone

(301) 515-3333

Fax

(301) 515-3322

NPI assigned

Jun 20, 2007

Last updated

Aug 26, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Harpal S Mangat, MD

Title

Vice President

Phone

(301) 515-3333

Specialties & licenses 7

Addresses

Other identifiers 1

Other names 1

• Clarksburg Medical Center Doing business as

Locations

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282780800000",
    "number": "1174728851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23208 BREWERS TAVERN WAY",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714391",
            "telephone_number": "301-515-3333",
            "fax_number": "301-515-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23208 BREWERS TAVERN WAY",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714391",
            "telephone_number": "301-515-3333",
            "fax_number": "301-515-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSBURG MED INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2010-08-26",
        "status": "A",
        "authorized_official_last_name": "MANGAT",
        "authorized_official_first_name": "HARPAL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "301-515-3333",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "416697300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarksburg Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Clarksburg, MD
• Providers in Clarksburg, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; 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.