CHARLES COUNTY SURGICAL ASSOCIATES, LLC (NPI# 1003002163) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003002163 |
| Entity Type | Organization |
| Organization Name | CHARLES COUNTY SURGICAL ASSOCIATES, LLC |
| Practice Address |
4225 Altamont Pl Unit 3 White Plains MD 20695-3063 |
| Practice Telephone | 3013749591 |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2007-09-21 |
| Authorized Official Name | ROBERT S BERGER (MD) |
| Authorized Official Telephone | 3013749591 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
4225 ALTAMONT PL UNIT 3 |
| City | WHITE PLAINS |
| State | MD |
| Zip Code | 20695-3063 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023590452 | Dominique Bouldin | Driver | 11136 Saint Christopher Drive, White Plains, MD 20695 | 2018-09-01 |
| 1366928665 | Wooten Lyons LLC | Psychiatry & Neurology | 10665 Stanhaven Place, Suite 300a, White Plains, MD 20695 | 2018-07-19 |
| 1962914507 | Kids By The Bay Dental LLC | Clinic/Center | 5010 Regency Place Ste 102, White Plains, MD 20695 | 2017-11-03 |
| 1528592896 | Darlena Austin | Social Worker | 5310 Exeter Place, White Plains, MD 20695 | 2017-04-13 |
| 1609307040 | Phylicia Wooten | Counselor | 5510 Regency Place Suite 203, White Plains, MD 20695 | 2017-03-27 |
| 1760856488 | Stephanie W Allen | Physical Therapist | Ospt South Office 4470 Regency Place, Suite #100, White Plains, MD 20695 | 2015-11-18 |
| 1457743122 | Raven Gray | Physical Therapy Assistant | 10708 Esprit Place, White Plains, MD 20695 | 2015-03-04 |
| 1043629850 | Adenike Kupolati | Pharmacist | 4220 Altamont Place, White Plains, MD 20695 | 2014-08-06 |
| 1942532064 | Divine Intervention Community Support Services | Community/Behavioral Health | 7727 Chesterfied Ct., White Plains, MD 20695 | 2010-02-01 |
| 1740517895 | Optionet Support Service | Community/Behavioral Health | 7727 Chesterfield Court, White Plains, MD 20695 | 2009-11-11 |
| Find all providers in zip 20695 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891267936 | Beckley Dermatology Inc. | Dermatology | 1110 Professional Ct Ste 201, Hagerstown, MD 21740-5945 | 2018-12-31 |
| 1518480136 | Forefront Dermatology, S.c. | Dermatology | 8134 Old Georgetown Rd, Bethesda, MD 20814 | 2017-07-25 |
| 1407014913 | Zaineb H Makhzoumi | Dermatology | 419 West Redwood Street, Suite 260, Baltimore, MD 21201 | 2008-05-30 |
| 1164458873 | Eric Finzi | Dermatology | 7701 Greenbelt Rd, 504, Greenbelt, MD 20770-2037 | 2006-06-24 |
| 1982670980 | Andrew Denis Montemarano | Dermatology | 6410 Rockledge Drive, Suite 300, Bethesda, MD 20817-7811 | 2006-02-28 |
| 1720059736 | David S Mezebish | Dermatology | 9711 Medical Center Dr Ste 307, Rockville, MD 20850-3385 | 2006-01-28 |
| 1942282371 | Michael Rebert Warner | Dermatology | 63 Thomas Johnson Dr, Suite B, Frederick, MD 21702-4384 | 2005-11-21 |
| 1659900850 | Cronin Dermatology and Skin Cancer | Dermatology | 5530 Wisconsin Ave Ste 1418, Chevy Chase, MD 20815-4302 | 2020-04-08 |
| 1821582917 | Charles B Toner Md Pa | Dermatology | 9131 Piscataway Rd Ste 550, Clinton, MD 20735 | 2018-06-21 |
| 1689950610 | Dal Dermatology, Inc. | Dermatology | 26215 Ridge Rd, Damascus, MD 20872-1829 | 2011-10-21 |
| Find all providers with the same taxonomy | ||||
| City | WHITE PLAINS |
| Zip Code | 20695 |
Please comment or provide details below to improve the information on CHARLES COUNTY SURGICAL ASSOCIATES, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.