Mid Atlantic Surgical Group

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

MID ATLANTIC SURGICAL GROUP

Practice address

11103 Cathage Rd
Berlin, MD 21811-2114

Phone

(410) 543-9332

Fax

(410) 543-9237

NPI assigned

Jun 3, 2024

Organization subpart

No

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

Authorized official

Name

Kristy Gunderson

Title

Office Manager

Phone

(410) 543-9332

Specialties & licenses 1

Addresses

Tax ID family

Mid Atlantic Surgical Group3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Mid Atlantic Surgical Group

  • Surgery Physician
  • Salisbury, MD
  • NPI 1013758432
  NPD tax ID
• Mid Atlantic Surgical Group

  • Surgery Physician
  • Salisbury, MD
  • NPI 1932940251
  NPD tax ID

Locations

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1922849348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6507 DEER POINTE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218041667",
            "telephone_number": "410-543-9332",
            "fax_number": "410-543-9237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11103 CATHAGE RD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218112114",
            "telephone_number": "410-543-9332",
            "fax_number": "410-543-9237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC SURGICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-02",
        "status": "A",
        "authorized_official_last_name": "GUNDERSON",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-543-9332"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Renee Menzel, LCSW-C
• Katherine Meredith
• Bernard W Merritt II
• Jeffery Charles Michael, D.C.
• Zachary Michalov, DPT
• Mid-Atlantic Long Term Care, LLC
• Mid-Atlantic Pharmacy, LLC
• Tyrese Milbourne
• Jennifer Miller, PHARMD
• Laura Miller, M.S.

• Surgery Physician in Berlin, MD
• Providers in Berlin, MD by specialty
• Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.