Organization Active NPI

Medstar Medical Group - Southern Maryland LLC

Doing business as MedStar Shah Medical Group LLC

  • Internal Medicine Physician
  • Prince Frederick, MD
National Provider Identifier
1477350403
Registry record updated Dec 15, 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
Doing business as
MedStar Shah Medical Group LLC
Practice address
130 Hospital Rd Ste 300
Prince Frederick, MD 20678-4057
Phone
(410) 535-4333
Fax
(410) 535-0495
NPI assigned
Feb 27, 2025
Last updated
Dec 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 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 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X
Internal Medicine Physician 207R00000X Primary
Cardiovascular Disease Physician 207RC0000X
Gastroenterology Physician 207RG0100X
Nephrology Physician 207RN0300X
Pulmonary Disease Physician 207RP1001X

Addresses

Primary practice location

130 Hospital Rd Ste 300
Prince Frederick, MD 20678-4057

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": "1765756800000",
    "number": "1477350403",
    "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": "130 HOSPITAL RD STE 300",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784057",
            "telephone_number": "410-535-4333",
            "fax_number": "410-535-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-27",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "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": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.