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General NPI Number Information
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NPI Number | 1760406110
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Entity Type | Organization
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Legal Business Name | MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 7700 OLD BRANCH AVE SUITE 104A
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City | CLINTON
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State | MD
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Zip | 20735
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Country | US
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Telephone | 301-868-8888
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Fax | 301-868-0409
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Provider Business Mailing Address
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Address Line | 10403 HOSPITAL DRIVE SUITE G-04
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City | CLINTON
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State | MD
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Zip | 20735-3134
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Country | US
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Telephone | 301-856-3019
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Fax | 301-856-9370
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JANE RAYMOND
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Credential |
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Telephone | 301-856-3019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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