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General NPI Number Information
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NPI Number | 1700733441
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Entity Type | Organization
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Legal Business Name | MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 10583 THEODORE GREEN BLVD
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City | WHITE PLAINS
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State | MD
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Zip | 20695-3022
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Country | US
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Telephone | 301-934-9300
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Fax | 301-934-6963
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Provider Business Mailing Address
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Address Line | 24035 THREE NOTCH RD
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City | HOLLYWOOD
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State | MD
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Zip | 20636-4871
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Country | US
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Telephone | 301-373-7900
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Fax | 301-373-6900
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Authorized Official
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Title or Position | COO
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Name | ALAN ADAIR BUSTER JR.
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Credential |
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Telephone | 301-373-7905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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