# SOUTHERN MARYLAND MEDICAL GROUP LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** SOUTHERN MARYLAND MEDICAL GROUP LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1215747563
- **Legal business name:** SOUTHERN MARYLAND MEDICAL GROUP LLC
- **Authorized official:** GIRISH SADASHIVA RAO MD (PARTNER)
- **Authorized official phone:** (301) 452-7945

## Contact information

- **Practice address:** 6510 KENILWORTH AVE STE 1400, RIVERDALE, MD 20737-1339
- **Practice address phone:** (301) 618-0771
- **Mailing address:** 7500 GREENWAY CENTER DR STE 1200, GREENBELT, MD 20770-3556
- **Mailing address phone:** (301) 486-7580
- **Mailing address fax:** (301) 486-7581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/09/2025
- **Last updated:** 01/09/2025