Healthcare Provider Details
I. General information
NPI: 1083667067
Provider Name (Legal Business Name): MARYLAND PRIMARY CARE PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/18/2006
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
129 LUBRANO DR STE 100
ANNAPOLIS MD
21401-7566
US
IV. Provider business mailing address
7580 BUCKINGHAM BLVD STE 220
HANOVER MD
21076-3210
US
V. Phone/Fax
- Phone: 410-266-5852
- Fax:
- Phone: 410-729-5100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
S.
RIEBMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 410-729-5100