Organization
CIVISTA CLINICAL SERVICES, LLC
Active
Parent organization
CIVISTA CLINICAL SERVICES, LLC
Other names
University of Maryland Charles Regional OB/GYN
Organization subpart
Yes
Provider details
NPI number
Legal business name
CIVISTA CLINICAL SERVICES, LLC
Authorized official
STEPHANIE SIMM (PHYSICIAN RELATIONS SPECIALISTS)
(301) 609-4539
Entity
Organization
Contact information
Practice address
605 EAST CHARLES STREET, LA PLATA, MD 20646
(301) 609-4800
(301) 609-5220
Mailing address
605 EAST CHARLES STREET, LA PLATA, MD 20646
(301) 609-4800
(301) 609-5220
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
07/13/2007
Last updated
05/15/2015
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