NPIMap

Organization Active NPI

Medstar Medical Group - Southern Maryland LLC

  • Surgery Physician
  • Waldorf, MD
National Provider Identifier
1639019573
Registry record updated May 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
Practice address
3261 Old Washington Rd 1012
Waldorf, MD 20602-3228
Phone
(301) 843-9060
Fax
(301) 645-3092
NPI assigned
Mar 31, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2026

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

Authorized official

Name
Alan Adair Buster Jr.
Title
Coo
Phone
(301) 373-7905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

3261 Old Washington Rd 1012
Waldorf, MD 20602-3228

Mailing address

24035 Three Notch Rd
Hollywood, MD 20636-4871
Phone (301) 373-7900

National Provider Directory

National Provider Directory
Tax ID family
Medstar Medical Group30 organizations share this tax ID, including this one

Other organizations with this tax ID 29

Organizations that report the same tax identification number in the National Provider Directory.

View all 29

Locations

3261 Old Washington Rd
Ste 1012
Waldorf, MD 20602
Phone (301) 843-9060

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1774915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1778457600000",
    "number": "1639019573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24035 THREE NOTCH RD",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206364871",
            "telephone_number": "301-373-7900",
            "fax_number": "301-373-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3261 OLD WASHINGTON RD 1012",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023228",
            "telephone_number": "301-843-9060",
            "fax_number": "301-645-3092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-31",
        "last_updated": "2026-05-11",
        "certification_date": "2026-05-11",
        "status": "A",
        "authorized_official_last_name": "BUSTER",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "ADAIR",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "301-373-7905",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; 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.