Healthcare Provider Details

I. General information

NPI: 1881515690
Provider Name (Legal Business Name): MONARCH CONCIERGE MD OF MARYLAND, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18111 PRINCE PHILIP DR STE 200
OLNEY MD
20832-1513
US

IV. Provider business mailing address

18111 PRINCE PHILIP DR STE 200
OLNEY MD
20832-1513
US

V. Phone/Fax

Practice location:
  • Phone: 301-774-7714
  • Fax: 301-686-7164
Mailing address:
  • Phone: 301-774-7714
  • Fax: 301-686-7164

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BRANDON SHAW
Title or Position: OWNER
Credential: DO
Phone: 602-300-9699