NPIMap

Organization Active NPI

Southern Maryland Hospital, Inc

  • Internal Medicine Physician
  • Clinton, MD
National Provider Identifier
1508055120
Registry record updated Nov 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SOUTHERN MARYLAND HOSPITAL, INC
Practice address
7503 Surratts Road
Clinton, MD 20735-3358
Phone
(301) 870-7001
Fax
(301) 870-6697
NPI assigned
Oct 19, 2007
Organization subpart
Yes
Parent organization
SOUTHERN MARYLAND HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 7, 2011

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

Authorized official

Name
Mr. Charles R. Stewart
Title
Cfo
Phone
(301) 877-4541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

7503 Surratts Road
Clinton, MD 20735-3358

Mailing address

7503 Surratts Road
Clinton, MD 20735-3358
Phone (301) 870-7001

Other identifiers 2

IdentifierTypeStateIssuer
9369, LR78OtherMDBLUE CROSS BLUE SHIELD NCA & MD.
410566400MedicaidMD

Other names 1

  • Department of Medical Surgical Doing business as

National Provider Directory

National Provider Directory
Part of
Sothern Maryland Hospit

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320624000000",
    "number": "1508055120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7503 SURRATTS ROAD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353358",
            "telephone_number": "301-870-7001",
            "fax_number": "301-870-6697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7503 SURRATTS ROAD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353358",
            "telephone_number": "301-870-7001",
            "fax_number": "301-870-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MARYLAND HOSPITAL, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTHERN MARYLAND HOSPITAL, INC.",
        "enumeration_date": "2007-10-19",
        "last_updated": "2011-11-07",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-877-4541",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD NCA & MD.",
            "identifier": "9369, LR78",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "410566400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department of Medical Surgical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2011; 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.