Suburban Orthopaedic,Total Joint and Sports Clinic,P.C.

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

D0022051 Issued in MD

Legal business name

SUBURBAN ORTHOPAEDIC,TOTAL JOINT AND SPORTS CLINIC,P.C.

Practice address

11701 Livingston Rd
Suite 105
Fort Washington, MD 20744-5104

Phone

(301) 292-7447

Fax

(301) 292-3278

NPI assigned

Mar 26, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Samir Naguib Azer, MD

Title

President

Phone

(301) 292-7447

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238716800000",
    "number": "1508983115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11701 LIVINGSTON RD",
            "address_2": "SUITE 105",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445104",
            "telephone_number": "301-292-7447",
            "fax_number": "301-292-3278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 LIVINGSTON RD",
            "address_2": "SUITE 105",
            "city": "FORT WASHINGTON",
            "state": "MD",
            "postal_code": "207445104",
            "telephone_number": "301-292-7447",
            "fax_number": "301-292-3278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN ORTHOPAEDIC,TOTAL JOINT AND SPORTS CLINIC,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-26",
        "last_updated": "2009-04-03",
        "status": "A",
        "authorized_official_last_name": "AZER",
        "authorized_official_first_name": "SAMIR",
        "authorized_official_middle_name": "NAGUIB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-292-7447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MD",
            "license": "D0022051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "782111500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sports Pro Physical Therapy South LLC
• William Stinson Jr.
• Amber C Stokes, PHARMD
• Strategic Screening & Diagnostics, LLC
• Suburban Orthopaedic Total Joint and Sports Clinic, P.C.
• Rattanakorn Suksaby, OTR/L
• James Eugene Sullivan, D.D.S.
• Rediat Tadesse
• Zenash Gizaw Tadesse
• Elizabeth Park Tanner, M.D.

• Sports Medicine (Orthopaedic Surgery) Physician in Fort Washington, MD
• Providers in Fort Washington, MD by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2009; 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.