NPIMap

Organization Active NPI

Medstar Medical Group, LLC

  • Internal Medicine Physician
  • Glen Burnie, MD
National Provider Identifier
1346514817
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDSTAR MEDICAL GROUP, LLC
Practice address
1406 Crain Highway
Suite 106
Glen Burnie, MD 21061-4058
Phone
(410) 768-6440
NPI assigned
Mar 1, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Authorized official

Name
Edward Miller, M.D.NPI 1154317642
Title
Vice President
Phone
(443) 725-8719

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1406 Crain Highway
Suite 106
Glen Burnie, MD 21061-4058

Mailing address

8094 Sandpiper Cir
Suite O
Baltimore, MD 21236-4907
Phone (410) 933-3017

National Provider Directory

National Provider Directory

Locations

1145 19th St NW
Ste 311
Washington, DC 20036
Phone (202) 429-2401

4700 Berwyn House Rd
Ste 104
College Park, MD 20740
Phone (301) 441-1511

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1346514817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8094 SANDPIPER CIR",
            "address_2": "SUITE O",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212364907",
            "telephone_number": "410-933-3017",
            "fax_number": "410-933-3019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 CRAIN HIGHWAY",
            "address_2": "SUITE 106",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614058",
            "telephone_number": "410-768-6440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-725-8719",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.