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Contact Information

CLARKSBURG MED INC
23208 BREWERS TAVERN WAY
CLARKSBURG, MD20871-4391
 Phone: 301-515-3333
 Fax: 301-515-3322
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Adult Medicine

207QA0505X 08 Physician/Family Practice
 

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
 

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Sleep Medicine

207RS0012X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CLARKSBURG MED INC · (Female)

NPI Number 1174728851
Status Active
Credentials
Entity Individual
Enumeration date 06/20/2007
Last updated 08/26/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • MD Medicaid 416697300
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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