# CLARKSBURG MED INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clarksburg Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174728851
- **Authorized official:** HARPAL S MANGAT MD (VICE PRESIDENT)
- **Authorized official phone:** (301) 515-3333

## Contact information

- **Practice address:** 23208 BREWERS TAVERN WAY, CLARKSBURG, MD 20871-4391
- **Practice address phone:** (301) 515-3333
- **Practice address fax:** (301) 515-3322
- **Mailing address:** 23208 BREWERS TAVERN WAY, CLARKSBURG, MD 20871-4391
- **Mailing address phone:** (301) 515-3333
- **Mailing address fax:** (301) 515-3322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 207QA0505X | Adult Medicine Physician | — | NULL | — |
| 207QA0505X | Adult Medicine Physician | — | — | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | NULL | — |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RG0300X | Geriatric Medicine (Internal Medicine) Physician | — | — | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | NULL | — |
| 207RS0012X | Sleep Medicine (Internal Medicine) Physician | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | — |
| 207W00000X | Ophthalmology Physician | — | — | — |

## Other

- **Enumeration date:** 06/20/2007
- **Last updated:** 08/26/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 416697300 | — | MD |