Organization
MEDSTAR MEDICAL GROUP - SOUTHERN MARYLAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN ADAIR BUSTER JR. (C.O.O.)
(301) 373-7905
Entity
Organization
Contact information
Practice address
130 HOSPITAL DRIVE, STE 300, PRINCE FREDERICK, MD 20678-4057
(301) 373-7900
(301) 373-6900
Mailing address
24035 THREE NOTCH RD, HOLLYWOOD, MD 20636-4871
(301) 373-7900
(301) 373-6900
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423411104
—
MD
Enumeration date
05/29/2026
Last updated
05/29/2026
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