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General NPI Number Information
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NPI Number | 1063721629
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Entity Type | Organization
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Legal Business Name | CLARKSBURG MEDICAL CENTER INC
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Dates
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Enumeration Date | 09/30/2010
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Last Update Date | 12/26/2018
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Provider Practice Location Address
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Address Line | 22616 GATEWAY CENTER DR STE 600A
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City | CLARKSBURG
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State | MD
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Zip | 20871
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Country | US
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Telephone | 301-515-3333
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Fax | 301-515-3322
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Provider Business Mailing Address
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Address Line | 22616 GATEWAY CENTER DR STE 600A
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City | CLARKSBURG
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State | MD
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Zip | 20871-2011
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Country | US
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Telephone | 301-515-3333
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Fax | 301-515-3322
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HARPAL SINGH MANGAT
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Credential | MD
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Telephone | 301-515-3333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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