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Organization

MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC

Active
Other names
MedStar Shah Medical Group LLC
Organization subpart
No

Provider details

NPI number
Authorized official
ALAN ADAIR BUSTER (CREDENTIALING)
(301) 373-7905
Entity
Organization

Contact information

Practice address
9131 PISCATAWAY RD STE 610, CLINTON, MD 20735-2568
(301) 868-2106
(301) 868-6757
Mailing address
24035 THREE NOTCH RD, HOLLYWOOD, MD 20636-4871
(301) 373-7900
(301) 373-6900

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician

Other

Enumeration date
02/27/2025
Last updated
08/01/2025
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