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Contact Information

MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
37767 MARKET DR 2ND FLOOR
CHARLOTTE HALL, MD20622-3188
 Phone: 301-884-7322
 Fax: 301-884-8663
 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
 

Neurology

2084N0400X 13 Physician/Neurology
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

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

NPI Number 1912704941
LBN Legal business name MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
Authorized official ALAN BUSTER - (CREDENTIALING)
Entity Organization
Organization subpart 1 No
Enumeration date 02/27/2025
Last updated 08/01/2025 - 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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