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NPI Code Detail

MEDICARE: SOUTHERN MARYLAND MEDICAL GROUP LLC

MEDICARE: SOUTHERN MARYLAND 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
1207Q00000XFamily Medicine Physician
2207RC0000XCardiovascular Disease Physician
3207RI0011XInterventional Cardiology Physician
4261QP2000XPhysical Therapy Clinic/Center
5207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1942448113
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTHERN MARYLAND MEDICAL GROUP LLC
Provider Business Mailing Address
First Line : 7500 GREENWAY CENTER DR STE 1200
Second Line :
City : GREENBELT
State : MD
Zip : 20770-3556
Country : US
Telephone Number : 301-486-7580
Fax Number : 301-486-7581
Provider Business Practice Location Address
First Line : 5801 ALLENTOWN RD STE 400
Second Line :
City : CAMP SPRINGS
State : MD
Zip : 20746-4585
Country : US
Telephone Number : 301-868-0150
Fax Number : 301-868-0243
Authorized Official
Title or Position : MANAGING PHYSICIAN
Name : GIRISH SADASHIVA RAO
Credential : MD
Telephone Number : 301-552-1200
Provider Enumeration Date : 01/27/2009
Last Update Date : 01/03/2025

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Directions to “SOUTHERN MARYLAND MEDICAL GROUP LLC ” Practice Location

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