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Organization

MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC

Active
Other names
WALDORF ENT
Organization subpart
No

Provider details

NPI number
Authorized official
JANE RAYMOND (VP)
(301) 868-3019
Entity
Organization

Contact information

Practice address
10 SAINT PATRICKS DR, SUITE 202, WALDORF, MD 20603-4527
(301) 396-8071
(301) 396-4671
Mailing address
10403 HOSPITAL DR, SUITE G4, CLINTON, MD 20735-3134
(301) 868-3019
(301) 856-9370

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD

Other

Enumeration date
01/19/2011
Last updated
03/15/2013
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