Southern Maryland Pulmonary & Critical Care, P.a.

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

D4760773 Issued in MD

Legal business name

SOUTHERN MARYLAND PULMONARY & CRITICAL CARE, P.A.

Doing business as

So. MD. Pulmonary & Critical Care

Practice address

3575 Old Washington Rd
Suite C
Waldorf, MD 20602-3269

Phone

(301) 645-3420

Fax

(301) 645-3423

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Song C Chon, D12587

Title

Owner/Partner

Phone

(301) 645-3420

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SO. MD. PULMONARY & CRITICAL CARE Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Hilfiker, PA-C

  • Medical Physician Assistant
  • Waldorf, MD
  • NPI 1013193036
  NPD (past)
• Sanjeeb K Mishra, M.D.

  • Nephrology Physician
  • Waldorf, MD
  • NPI 1932171345
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358467200000",
    "number": "1982782686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 OLD WASHINGTON RD",
            "address_2": "SUITE C",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023269",
            "telephone_number": "301-645-3420",
            "fax_number": "301-645-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 OLD WASHINGTON RD",
            "address_2": "SUITE C",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023269",
            "telephone_number": "301-645-3420",
            "fax_number": "301-645-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MARYLAND PULMONARY & CRITICAL CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2013-01-18",
        "status": "A",
        "authorized_official_last_name": "CHON",
        "authorized_official_first_name": "SONG",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "301-645-3420",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D12587"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MD",
            "license": "D4760773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "741232100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CH4678",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SO. MD. PULMONARY & CRITICAL CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pulmonary Disease Physician in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Pulmonary Disease Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2013; 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.