Organization
SOUTHERN MARYLAND PRIMARY CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIRAN P SHARMA MD (OWNER)
(301) 638-9670
Entity
Organization
Contact information
Practice address
3460 OLD WASHINGTON RD, SUITE 203A, WALDORF, MD 20602-3240
(301) 638-9670
(301) 638-7558
Mailing address
PO BOX 1558, WALDORF, MD 20604-1558
(301) 638-9670
(301) 638-7558
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D78727
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431203100
—
MD
01
—
F247
BLUE CROSS
DC
Enumeration date
09/26/2007
Last updated
12/18/2012
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