Eastern Shore Internist LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

EASTERN SHORE INTERNIST LLC

Practice address

5484 Dunfries CT
Salisbury, MD 21801-2474

Phone

(202) 352-5613

NPI assigned

Nov 25, 2024

Organization subpart

No

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

Authorized official

Name

Shahabuddin Soherwardi, M.D.NPI 1548646383

Title

Authorized Official

Phone

(202) 352-5613

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shahabuddin Soherwardi, MD

  • Internal Medicine Physician
  • Salisbury, MD
  • NPI 1548646383
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732492800000",
    "number": "1508682576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5484 DUNFRIES CT",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012474",
            "telephone_number": "202-352-5613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5484 DUNFRIES CT",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012474",
            "telephone_number": "202-352-5613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE INTERNIST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A",
        "authorized_official_last_name": "SOHERWARDI",
        "authorized_official_first_name": "SHAHABUDDIN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "202-352-5613",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eastern Shore Cardiovascular Assoc. P.a.
• Eastern Shore Counseling Associates, Inc. (Caounseling Associates)
• Eastern Shore Eldercare LLC
• Eastern Shore Endodontics, P.a.
• Eastern Shore ENT & Allergy
• Eastern Shore Medical Center Mental Health & Wellness, LLC
• Eastern Shore Medical Center PA
• Eastern Shore Orthopaedics
• Eastern Shore Pediatric Dentistry, LLC
• Eastern Shore Pediatrics

• Internal Medicine Physician in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.