{
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"FirstLineMailingAddress": "7902 OLD BRANCH AVE STE 107",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLINTON",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20735-1627",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "240-318-3502",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "7902 OLD BRANCH AVE STE 107",
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"PracticeLocationAddressCityName": "CLINTON",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/13/2018",
"LastUpdateDate": "02/13/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CUMMINGS",
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"AuthorizedOfficialCredential": "CAMSI",
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"Taxonomies": {
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"TaxonomyName": "Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}