Organization
SOUTH MOUNTAIN FAMILY PRACTICE LLC
Active
Organization
SOUTH MOUNTAIN FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM F BODENHEIMER III MD (OWNER)
(301) 432-0623
Entity
Organization
Contact information
Practice address
9 SAINT PAUL ST, BOONSBORO, MD 21713-1334
(301) 432-0623
(301) 432-0624
Mailing address
9 SAINT PAUL ST, BOONSBORO, MD 21713-1334
(301) 432-0623
(301) 432-0624
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
D0056826
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
864001700
—
MD
Enumeration date
07/26/2007
Last updated
06/29/2011
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up