# MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC
- **Other names:** MedStar Southern Maryland Women's Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1316340201
- **Legal business name:** MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC
- **Authorized official:** JANE E. RAYMOND (V.P. OF PHYSICIAN SERVICES)
- **Authorized official phone:** (301) 877-4530

## Contact information

- **Practice address:** 11340 PEMBROOKE SQ, SUITE 203, WALDORF, MD 20603-4808
- **Practice address phone:** (301) 843-7737
- **Practice address fax:** (301) 932-7917
- **Mailing address:** 11340 PEMBROOKE SQ, SUITE 203, WALDORF, MD 20603-4808
- **Mailing address phone:** (301) 843-7737
- **Mailing address fax:** (301) 932-7917

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/06/2014
- **Last updated:** 10/06/2014