Charles S. Samorodin MD, PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

D12936 Issued in MD

Legal business name

CHARLES S. SAMORODIN MD, PA

Practice address

54 Scott Adam Rd
Suite 201
Cockeysville, MD 21030-3292

Phone

(410) 628-2266

Fax

(410) 628-2653

NPI assigned

Mar 10, 2010

Organization subpart

No

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

Authorized official

Name

Charles Steven Samorodin, M.D.

Title

Dermatologist

Phone

(410) 628-2266

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268179200000",
    "number": "1679896252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 SCOTT ADAM ROAD",
            "address_2": "SUITE 201",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303292",
            "telephone_number": "410-628-2266",
            "fax_number": "410-628-2653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 SCOTT ADAM RD",
            "address_2": "SUITE 201",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303292",
            "telephone_number": "410-628-2266",
            "fax_number": "410-628-2653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES S. SAMORODIN MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-10",
        "last_updated": "2010-03-10",
        "status": "A",
        "authorized_official_last_name": "SAMORODIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "STEVEN",
        "authorized_official_title_or_position": "DERMATOLOGIST",
        "authorized_official_telephone_number": "410-628-2266",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "MD",
            "license": "D12936",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051531100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Cockeysville, MD
• Providers in Cockeysville, MD by specialty
• Dermatology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 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.