MEDICARE: SILVER SPRING MEDICAL GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	207R00000X	Internal Medicine Physician	D82050	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	D82050	OTHER	MD	PHYSICIAN LICENSE #

General Provider Information

NPI Number	:	1275083511
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER SPRING MEDICAL GROUP LLC

Provider Business Mailing Address
First Line	:	6915 LAUREL BOWIE RD STE 101
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20715-1715
Country	:	US
Telephone Number	:	301-262-1087
Fax Number	:	240-436-2850

Provider Business Practice Location Address
First Line	:	6915 LAUREL BOWIE RD STE 101
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20715-1715
Country	:	US
Telephone Number	:	301-262-1087
Fax Number	:	240-436-2850

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ARVIND PABLA
Credential	:
Telephone Number	:	301-262-1087

Provider Enumeration Date	:	10/11/2016
Last Update Date	:	05/17/2019

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Directions to “SILVER SPRING MEDICAL GROUP LLC ” Practice Location

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