MEDICARE: MEDSTAR MEDICAL GROUP II 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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1760324453
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDSTAR MEDICAL GROUP II LLC

Provider Business Mailing Address
First Line	:	3007 TILDEN ST NW STE 5N
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-3030
Country	:	US
Telephone Number	:	706-558-1403
Fax Number	:

Provider Business Practice Location Address
First Line	:	4201 CONNECTICUT AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20008-1158
Country	:	US
Telephone Number	:	855-910-3278
Fax Number	:

Authorized Official
Title or Position	:	VP
Name	:	STEPHANIE SCHNEIDER
Credential	:
Telephone Number	:	702-558-1403

Provider Enumeration Date	:	04/09/2026
Last Update Date	:	04/09/2026

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