| University of Maryland Community Medical Group, Inc. | |
|
255 Hospital Dr Ste 108 Glen Burnie MD 21061-5801 | |
| (410) 757-4675 | |
| Not Available |
| Full Name | University of Maryland Community Medical Group, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 255 Hospital Dr Ste 108, Glen Burnie, Maryland |
| Authorized Official Name and Position | Paul Stephen Nicholson (SENIOR VICE PRESIDENT) |
| Authorized Official Contact | 4103371602 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| University of Maryland Community Medical Group, Inc. 900 Elkridge Landing Rd Fl 2 Linthicum MD 21090-2924 Ph: (443) 462-5010 | University of Maryland Community Medical Group, Inc. 255 Hospital Dr Ste 108 Glen Burnie MD 21061-5801 Ph: (410) 757-4675 |
| NPI Number | 1396536140 |
|---|---|
| Provider Enumeration Date | 05/13/2025 |
| Last Update Date | 05/13/2025 |
| Certification Date | 05/13/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396536140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 208000000X | Pediatrics | () | Secondary |
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