Susan A Demuth, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101037909 Issued in VA

Practice address

2480 Llewellyn Ave
Ft Meade, MD 20755-5800

Phone

(301) 677-8641

Fax

(301) 677-8485

NPI assigned

Oct 26, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Susan A Shultis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1730179284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "KIMBROUGH AMBULATORY CARE CENTER",
            "address_2": "ATTN: MCXR-CR 2480 LLEWELLYN AVE.",
            "city": "FT. MEADE",
            "state": "MD",
            "postal_code": "20755",
            "telephone_number": "301-677-8270",
            "fax_number": "301-677-8176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE",
            "city": "FT MEADE",
            "state": "MD",
            "postal_code": "207555800",
            "telephone_number": "301-677-8641",
            "fax_number": "301-677-8485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMUTH",
        "first_name": "SUSAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101037909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "SHULTIS",
            "middle_name": "A",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Russell O Davis III, DO
• Tamatha Henderson Davis, LPN
• Sarah Deal, PSYD
• Kathleen Theresa Deck, PT
• Nancy Annette Demetrician, RN
• Swati Manoj Desai
• Amanda Droutsas
• Vickie R Ellis, LCSW
• Epes Dental Clinic
• Kathy Ann Espitia

• Pediatrics Physician in Ft Meade, MD
• Providers in Ft Meade, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.