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Organization
MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC
Active
Organization
MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORA KUCHKA-CRAIG (CORPORATE VICE PRESIDENT)
(410) 772-6827
Entity
Organization
Contact information
Practice address
7503 SURRATTS RD, CLINTON, MD 20735-3358
(301) 868-8000
Mailing address
7503 SURRATTS RD, CLINTON, MD 20735-3358
(301) 868-8000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
208M00000X
Hospitalist Physician
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
10/08/2012
Last updated
03/28/2024
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