University of Maryland Community Medical Group, Inc.

Organization Active NPI Family Medicine Physician · Waldorf, MD

NPI 1487404455 · NPPES record last updated Mar 25, 2024

Key facts

NPI
1487404455
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
Practice address
3510 Old Washington Rd Ste 200
Waldorf, MD 20602-3235
Phone
(240) 427-1800
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

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

National Provider Directory

Tax ID family
University of Maryland Community Medical Group Inc (171 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

3510 Old Washington Rd Ste 200
Waldorf, MD 20602-3235

Mailing address

900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924

Other providers in Waldorf, MD

All providers in Waldorf, MD · Family Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.