| University Of Maryland Community Medical Group, Inc. | |
|
5 Garrett Ave La Plata MD 20646-5960 | |
| (301) 609-4000 | |
| (301) 934-6493 |
| Full Name | University Of Maryland Community Medical Group, Inc. |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 5 Garrett Ave, La Plata, Maryland |
| Authorized Official Name and Position | Paul Stephen Nicholson (SENIOR VP, CFO) |
| Authorized Official Contact | 4103371602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University Of Maryland Community Medical Group, Inc. 900 Elkridge Landing Rd Fl 2 Linthicum MD 21090-2924 Ph: (443) 462-5010 | University Of Maryland Community Medical Group, Inc. 5 Garrett Ave La Plata MD 20646-5960 Ph: (301) 609-4000 |
| NPI Number | 1679393854 |
|---|---|
| Provider Enumeration Date | 10/14/2024 |
| Last Update Date | 10/14/2024 |
| Certification Date | 10/14/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679393854 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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