NPIMap

Organization Active NPI

Medstar Medical Group - Southern Maryland LLC

  • Internal Medicine Physician
  • Leonardtown, MD
National Provider Identifier
1417754458
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
Practice address
22650 Cedar Lane CT
Leonardtown, MD 20650-3965
Phone
(301) 475-5021
Fax
(301) 997-0264
NPI assigned
Feb 27, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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

Authorized official

Name
Alan Adair Buster
Title
C.O.O.
Phone
(301) 373-7905

Specialties & licenses 1

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

Addresses

Primary practice location

22650 Cedar Lane CT
Leonardtown, MD 20650-3965

Mailing address

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-7900

Other names 1

  • MedStar Shah Medical Group LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medstar Medical Group30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1740614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1755129600000",
    "number": "1417754458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206364871",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22650 CEDAR LANE CT",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503965",
            "telephone_number": "301-475-5021",
            "fax_number": "301-997-0264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A",
        "authorized_official_last_name": "BUSTER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "ADAIR",
        "authorized_official_title_or_position": "C.O.O.",
        "authorized_official_telephone_number": "301-373-7905"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedStar Shah Medical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MedStar Shah Medical Group LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2025; 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.