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Contact Information

MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
10 ST. PATRICK'S DRIVE
WALDORF, MD20603-4527
 Phone: 301-705-7870
 Fax: 240-448-2930
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Endocrinology, Diabetes & Metabolism

207RE0101X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
 

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
 

Infectious Disease

207RI0200X 11 Physician/Internal Medicine
 

Nephrology

207RN0300X 11 Physician/Internal Medicine
 

Neurology

2084N0400X 13 Physician/Neurology
 

Nuclear Medicine

207U00000X 36 Physician/Nuclear Medicine
 

Pain Medicine

2081P2900X 25 Physician/Physical Medicine and Rehabilitation
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
 

Rheumatology

207RR0500X 11 Physician/Internal Medicine
 

Sleep Medicine

207RS0012X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC

NPI Number 1629875661
LBN Legal business name MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
Authorized official ALAN BUSTER - (C.O.O.)
Entity Organization
Organization subpart 1 No
Enumeration date 02/27/2025
Last updated 08/14/2025 - About 10 months ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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