Cal Arundel Family Medicine, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

207Q00000X Issued in MD

Legal business name

CAL ARUNDEL FAMILY MEDICINE, LLC

Practice address

32 Cox Rd
Huntingtown, MD 20639-9278

Phone

(410) 414-9879

Fax

(410) 535-7684

NPI assigned

Nov 18, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Stanley John Wisniewski, M.D.

Title

Owner

Phone

(410) 414-9879

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1578891214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32 COX RD",
            "city": "HUNTINGTOWN",
            "state": "MD",
            "postal_code": "206399278",
            "telephone_number": "410-414-9879",
            "fax_number": "410-535-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 COX RD",
            "city": "HUNTINGTOWN",
            "state": "MD",
            "postal_code": "206399278",
            "telephone_number": "410-414-9879",
            "fax_number": "410-535-7684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAL ARUNDEL FAMILY MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-18",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "WISNIEWSKI",
        "authorized_official_first_name": "STANLEY",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-414-9879",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "207Q00000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1205845799",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "407730000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Huntingtown, MD
• Providers in Huntingtown, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.