# MEDSTAR SOUTHERN MARYLAND PHYSICIANS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316296791
- **Authorized official:** DEBORA J. KUCHKA-CRAIG (CORPORATE VICE PRESIDENT)
- **Authorized official phone:** (410) 772-6827

## Contact information

- **Practice address:** 7503 SURRATTS RD, CLINTON, MD 20735-3358
- **Practice address phone:** (301) 868-8000
- **Mailing address:** 7503 SURRATTS RD, CLINTON, MD 20735-3358
- **Mailing address phone:** (301) 868-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |

## Other

- **Enumeration date:** 08/31/2012
- **Last updated:** 03/28/2024