Organization
SOUTHERN MARYLAND HOSPITAL, INC.
Active
Parent organization
SOUTHERN MARYLAND HOSPITAL, INC.
Other names
Department of Physical Medicine
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN MARYLAND HOSPITAL, INC.
Authorized official
MR. CHARLES R. STEWART (CFO)
(301) 877-4541
Entity
Organization
Contact information
Practice address
7503 SURRATTS RD, CLINTON, MD 20735-3358
(301) 870-7001
(301) 870-6697
Mailing address
7503 SURRATTS RD, CLINTON, MD 20735-3358
(301) 870-7001
(301) 870-6697
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
410570200
—
MD
01
—
8179, LR78SO
CAREFIRST NCA & MARYLAND GROUP NUMBERS
MD
Enumeration date
10/19/2007
Last updated
05/14/2008
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