# MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Upper Marlboro Family Medical Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427093343
- **Authorized official:** JANE RAYMOND (VICE PRESIDENT)
- **Authorized official phone:** (301) 856-3019

## Contact information

- **Practice address:** 6409 SOUTH CRAIN HIGHWAY, ROUTE 301, UPPER MARLBORO, MD 20772
- **Practice address phone:** (301) 952-8614
- **Practice address fax:** (301) 952-9030
- **Mailing address:** 10403 HOSPITAL DRIVE, SUITE G-4, CLINTON, MD 20735-3134
- **Mailing address phone:** (301) 856-3019
- **Mailing address fax:** (301) 856-9370

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 03/15/2013