NPIMap

Organization Active NPI

Mdics at Southern Maryland LLC

  • Hospitalist Physician
  • Clinton, MD
National Provider Identifier
1972899243
Registry record updated Oct 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
D0039037 Issued in MD
Legal business name
MDICS AT SOUTHERN MARYLAND LLC
Practice address
7503 Surratts Rd
Clinton, MD 20735-3358
Phone
(443) 949-0814
Fax
(443) 949-0825
NPI assigned
Jun 24, 2011
Organization subpart
Yes
Parent organization
MDICS MANAGEMENT, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2012

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

Authorized official

Name
Dr. Douglas S Mitchell, MD
Title
Medical Director
Phone
(443) 949-0814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X D0039037 MD Primary

Addresses

Primary practice location

7503 Surratts Rd
Clinton, MD 20735-3358

Mailing address

6934 Aviation Blvd
Suite B
Glen Burnie, MD 21061-2593
Phone (443) 949-0814

National Provider Directory

National Provider Directory

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350345600000",
    "number": "1972899243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6934 AVIATION BLVD",
            "address_2": "SUITE B",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612593",
            "telephone_number": "443-949-0814",
            "fax_number": "443-949-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7503 SURRATTS RD",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353358",
            "telephone_number": "443-949-0814",
            "fax_number": "443-949-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDICS AT SOUTHERN MARYLAND LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MDICS MANAGEMENT, LLC",
        "enumeration_date": "2011-06-24",
        "last_updated": "2012-10-16",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "443-949-0814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "MD",
            "license": "D0039037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2012; 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.