University of Maryland Dermatologists PA

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

UNIVERSITY OF MARYLAND DERMATOLOGISTS PA

Practice address

100 Brown St
Chestertown, MD 21620-1435

Phone

(410) 328-5767

NPI assigned

Dec 18, 2024

Last updated

Dec 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shavonda L Williams

Title

Corporate Director

Phone

(667) 214-2507

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Baltimore, MD
  • NPI 1033927470

  O20040323000770

  Same enrollment
• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Lutherville, MD
  • NPI 1104623867

  O20040323000770

  Same enrollment
• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Baltimore, MD
  • NPI 1578371910

  O20040323000770

  Same enrollment
• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Columbia, MD
  • NPI 1659304152

  O20040323000770

  Same enrollment
• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Ellicott City, MD
  • NPI 1861368946

  O20040323000770

  Same enrollment
• University of Maryland Dermatologists PA

  • Clinical Medical Laboratory
  • Baltimore, MD
  • NPI 1912876855

  O20040323000770

  Same enrollment

Tax ID family

University of Maryland Dermatologists PA8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Baltimore, MD
  • NPI 1033927470
  NPD tax ID
• University of Maryland Dermatologists PA

  • Clinical Medical Laboratory
  • Baltimore, MD
  • NPI 1063388361
  NPD tax ID
• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Lutherville, MD
  • NPI 1104623867
  NPD tax ID
• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Baltimore, MD
  • NPI 1578371910
  NPD tax ID
• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Lutherville, MD
  • NPI 1770452633
  NPD tax ID
• University of Maryland Dermatologists PA

  • Dermatology Physician
  • Ellicott City, MD
  • NPI 1861368946
  NPD tax ID
• University of Maryland Dermatologists PA

  • Clinical Medical Laboratory
  • Baltimore, MD
  • NPI 1912876855
  NPD tax ID

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1881402212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64445",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROWN ST",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201435",
            "telephone_number": "410-328-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MARYLAND DERMATOLOGISTS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHAVONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CORPORATE DIRECTOR",
        "authorized_official_telephone_number": "667-214-2507"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• University of Maryland Community Medical Group, Inc.
• University of Maryland Community Medical Group, Inc.
• University of Maryland Community Medical Group, Inc.
• University of Maryland Community Medical Group, Inc.
• University of Maryland Community Medical Group, Inc.
• University of Maryland Diagnostic Imaging Specialists P a
• University of Maryland Pathology Associates, P.a.
• University of Maryland Pediatric Associates, PA
• University of Maryland Physicians P.a. (University of Maryland Medical Group)
• Upper Shore Community Mental Health Ctr

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.