NPI 1053166314

University of Maryland Community Medical Group, INC.

Organisation Family Medicine Physician La Plata, MD

Practice location

Address: 616 East Charles Street Suite 102, La Plata, MD 20646-5938
Phone: (301) 609-5445
Mailing address: 900 Elkridge Landing Rd Fl 2, Linthicum, MD 21090-2924

Authorised official

Name: Paul Stephen Nicholson
Title: Ao
Phone: (410) 337-1602

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in Maryland →

Registry record

NPI: 1053166314
Entity type: Organization
NPI issued: 20 Apr 2024
Record last updated: 20 Apr 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.