| University Of Maryland Community Medical Group, Inc. | |
|
12070 Old Line Ctr Waldorf MD 20602-2513 | |
| (301) 645-5100 | |
| Not Available |
| Full Name | University Of Maryland Community Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 12070 Old Line Ctr, Waldorf, Maryland |
| Authorized Official Name and Position | Paul Stephen Nicholson (SENIOR VICE PRESIDENT - CHIEF FINAN) |
| 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: () - | University Of Maryland Community Medical Group, Inc. 12070 Old Line Ctr Waldorf MD 20602-2513 Ph: (301) 645-5100 |
| NPI Number | 1902653231 |
|---|---|
| Provider Enumeration Date | 05/03/2024 |
| Last Update Date | 05/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902653231 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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