CLARKSBURG MEDICAL CENTER INC (NPI# 1063721629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063721629 |
| Entity Type | Organization |
| Organization Name | CLARKSBURG MEDICAL CENTER INC |
| Practice Address |
22616 Gateway Center Dr Ste 600a Clarksburg MD 20871 |
| Mailing Address |
22616 Gateway Center Dr Ste 600a Clarksburg MD 20871-2011 |
| Practice Telephone | 3015153333 |
| Practice Fax Number | 3015153322 |
| Mailing Telephone | 3015153333 |
| Mailing Fax Number | 3015153322 |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2018-12-26 |
| Authorized Official Name | DR. HARPAL SINGH MANGAT (PRESIDENT) |
| Authorized Official Telephone | 3015153333 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 23208 Brewers Tavern Way, Clarksburg, MD 208714391 | 3015153333 | 3015153322 |
| Street Address |
22616 GATEWAY CENTER DR STE 600A |
| City | CLARKSBURG |
| State | MD |
| Zip Code | 20871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366097578 | Shelah Maul | Speech-Language Pathologist | Clarksburg Elementary School, 13530 Redgrave Place, Clarksburg, MD 20871 | 2019-08-05 |
| 1013401769 | Thin Phyu Bur | Social Worker | 13446 Dutrow Dr, Clarksburg, MD 20871 | 2018-06-17 |
| 1750754925 | Milankumar Maheshbhai Patel | Physical Therapist | 23923 Basil Park Circle, Clarksburg, MD 20871 | 2015-11-09 |
| 1093142796 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 22700 Sweet Shrub Drive, Clarksburg, MD 20871 | 2013-09-26 |
| 1932493046 | Chidinma Ebele | Case Management | 23447 Tailor Shop Pl, Clarksburg, MD 20871 | 2011-06-06 |
| 1396036455 | Reliance Home Care | Home Health | 12615 Blue Sky Drive, Clarksburg, MD 20871 | 2011-04-25 |
| 1548440787 | Patricia J. Tucker | Social Worker | 21925 Frederick Rd, Clarksburg, MD 20871 | 2007-11-05 |
| 1316439078 | Clarksburg Dermatology and Skincare LLC | Nurse Practitioner | 23202 Brewers Tavern Way, Clarksburg, MD 20871 | 2018-05-30 |
| 1487954509 | Sean Park | Pharmacist | 7025 Brookville Rd, Chevy Chase, MD 20871 | 2010-10-22 |
| 1528331881 | Bio Reference Laboratories, Inc | Clinical Medical Laboratory | 22520 Gateway Center Dr, Ste 400, Clarksburg, MD 20871-2005 | 2012-02-17 |
| Find all providers in zip 20871 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780165738 | Praveen Bolarum, Md LLC | Internal Medicine | 23310 Frederick Rd, Clarksburg, MD 20871-9704 | 2018-08-28 |
| 1942234398 | Maria R Menez | Internal Medicine | 1medical Center Dr, Clarksburg, WV 26301 | 2006-07-10 |
| 1093030595 | Jyun Wang | Internal Medicine | 1 Medical Center Drive, Clarksburg, WV 26301 | 2010-03-29 |
| 1639260599 | Karen L. Skidmore | Internal Medicine | 1 Medical Center Drive, Clarksburg, WV 26301 | 2006-09-27 |
| 1396843090 | Atiya M. Lateef | Internal Medicine | 3 Hospital Plz, Clarksburg, WV 26301-9316 | 2006-09-20 |
| 1023125614 | Naveed Ul Haque | Internal Medicine | 1 Medical Center Drive, Clarksburg, WV 26301 | 2006-08-23 |
| 1205949351 | Lora Lynn Westfall | Internal Medicine | 1 Medical Center Drive, Clarksburg, WV 26301 | 2006-08-15 |
| 1063442465 | Dionisio Jose Rubi | Internal Medicine | 1 Med Center Dr, Clarksburg, WV 26301-4155 | 2006-07-03 |
| 1457313397 | David Grossman | Internal Medicine | 1 Medical Center Drive, Va Medical Center, Clarksburg, WV 26301 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114528353 | Barry Whitcomb Wolcott | Internal Medicine | 7353 Oskaloosa Dr, Derwood, MD 20855-2647 | 2020-11-04 |
| 1891396107 | Medacute Care LLC | Internal Medicine | 313 Skyview Dr, Cumberland, MD 21502-1929 | 2020-11-03 |
| 1689272262 | Marsha Seidelman, M.d., LLC | Internal Medicine | 10301 Georgia Ave Ste 304, Silver Spring, MD 20902-5020 | 2020-10-15 |
| 1770190647 | Medical Maryland Star Choice LLC | Internal Medicine | 2308 Pot Spring Rd, Luthvle Timon, MD 21093-2726 | 2020-09-25 |
| 1538774609 | Benchmark Medical LLC | Internal Medicine | 904 Stags Head Rd, Towson, MD 21286-1459 | 2020-09-15 |
| 1760090294 | Outreach Recovery II, LLC | Internal Medicine | 339 E Antietam St Ste 4, Hagerstown, MD 21740-5767 | 2020-07-21 |
| 1699398008 | Tb Medical | Internal Medicine | 10753 Falls Rd Ste 225, Lutherville, MD 21093-4597 | 2020-05-20 |
| 1073136693 | Bernard Willis Parker | Internal Medicine | 15239 Briarcliff Manor Way, Burtonsville, MD 20866-1662 | 2020-05-19 |
| 1134742695 | Dura Internal Medicine Limited Liability Company | Internal Medicine | 15225 Shady Grove Rd Ste 103, Rockville, MD 20850-3252 | 2020-05-19 |
| 1457973026 | Zeus Primary Care Associates LLC | Internal Medicine | 4701 Randolph Rd Ste 209a, Rockville, MD 20852-2257 | 2020-05-17 |
| Find all providers with the same taxonomy | ||||
| City | CLARKSBURG |
| Zip Code | 20871 |
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| 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.