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
National Provider Directory
- Tax ID family
- University of Maryland Community Medical Group Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
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
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- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
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All providers in Waldorf, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.