PRIME MD LLC (NPI# 1558540161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558540161 |
| Entity Type | Organization |
| Organization Name | PRIME MD LLC |
| Practice Address |
5005 Signal Bell Ln Suite 202 Clarksville MD 21029-2606 |
| Practice Telephone | 4435358500 |
| Practice Fax Number | 4105311446 |
| Mailing Telephone | 4435358500 |
| Mailing Fax Number | 4105311446 |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2010-09-16 |
| Authorized Official Name | DR. SUZAN KHALIL ABDO (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 4435358500 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | D50870 | MD | Residential Treatment Facilities |
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | D046855 | MD | Residential Treatment Facilities |
| Y | 207R00000X | Internal Medicine | D0050878 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | BSDC | F698 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952538167 | Prime Md LLC | Family Medicine | 10115 W Forest Hill Blvd, Suite 102, Wellington, FL 33414-3105 | 2009-06-15 |
| Street Address |
5005 SIGNAL BELL LN SUITE 202 |
| City | CLARKSVILLE |
| State | MD |
| Zip Code | 21029-2606 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508831223 | Aaron Raymond Twigg | Physical Medicine & Rehabilitation | 5005 Signal Bell Ln, Suite 208, Clarksville, MD 21029-2606 | 2006-02-17 |
| 1841662822 | Roy Bechtel | Physical Therapist | 5005 Signal Bell Ln, Suite 202, Clarksville, MD 21029-2606 | 2015-10-29 |
| 1154623452 | Maryland Spine and Sports Surgi-center, L.L.C. | Clinic/Center | 5005 Signal Bell Ln, Suite 207, Clarksville, MD 21029-2606 | 2010-11-19 |
| 1003136086 | Joel Howard Freedenberg | Dentist | 5005 Signal Bell Ln, #101, Clarksville, MD 21029-2606 | 2010-06-02 |
| 1821063165 | John Patrick Collins | Physical Medicine & Rehabilitation | 5005 Signal Bell Ln, Suite 208, Clarksville, MD 21029-2606 | 2006-02-21 |
| 1861467482 | Clark Robert Brill | Physical Medicine & Rehabilitation | 5005 Signal Bell Ln, Suite 208, Clarksville, MD 21029-2606 | 2006-02-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710436407 | Central Maryland Oral and Facial Surgical Arts of Clarksville, LLC | Dentist | 12431 Clarksville Pike, Route 108, Clarksville, MD 21029 | 2016-09-23 |
| 1740647262 | Darren Joseph | Physical Therapist | 6151 Daylong Lane, Clarksville, MD 21029 | 2016-01-28 |
| 1619302437 | Ashley Kneale | Physical Therapist | 6408 Silent Moon Run, Clarksville, MD 21029 | 2013-09-11 |
| 1780949693 | Jane Choi Council | Optometrist | 12345 Wake Forest Rd Ste E, Clarksville, MD 21029 | 2012-07-06 |
| 1598035248 | Jeffrey Stuart Abrams | Internal Medicine | 5073ten Oaks Rd, Clarksville, MD 21029 | 2012-01-11 |
| 1902102528 | Claudia Joe Salter | Psychologist | 6100 Daylong Ln Ste 103, Clarksville, MD 21029 | 2011-01-28 |
| 1285892430 | Mary Carol Wayda | Social Worker | 5905 Tall Branches Pass, Clarksville, MD 21029 | 2008-05-23 |
| 1407978422 | Basil Saiedy Dds LLC | Dentist | 6100 Day Long Lane, Suite 101, Clarksville, MD 21029 | 2007-04-03 |
| 1629329214 | Dina Michele Singer | Acupuncturist | 12451 Clarksville Pike, Clarksville, MD 21029 | 2012-09-24 |
| 1689796609 | Basil Saiedy | Dentist | 6100 Day Long Lane, Suite 101, Clarksville, MD 21029 | 2007-04-03 |
| Find all providers in zip 21029 | ||||
| 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 |
|---|---|---|---|---|
| 1932527090 | Healogics Specialty Physicians of Tennessee, Pllc | Internal Medicine | 647 Dunlop Ln Ste 108, Clarksville, TN 37040-6284 | 2014-04-04 |
| 1255621066 | Bruce D Spinzig Internal Medicine LLC | Internal Medicine | 1754 Madison Street, Suite 2, Clarksville, TN 37043-2924 | 2011-04-13 |
| 1073745717 | Khin Maung U | Internal Medicine | 6000 Pure Sky Pl, Clarksville, MD 21029-1238 | 2009-08-13 |
| 1376707216 | Rachel Owsiak | Internal Medicine | 141 Chesapeake Ln, Suite 300, Clarksville, TN 37040-5241 | 2008-07-10 |
| 1740487305 | Stephen Aulton White | Internal Medicine | 2289 Rudolphtown Rd Ste B, Clarksville, TN 37043-2231 | 2007-06-28 |
| 1376757054 | Rukhsana Ikram Rahman | Internal Medicine | 630 Eastern Blvd, Clarksville, IN 47129 | 2007-05-10 |
| 1407077928 | David T Schulz | Internal Medicine | 2051 Clevidence Blvd Ste A, Clarksville, IN 47129-2278 | 2007-05-01 |
| 1841312568 | Ehab T Shehata | Internal Medicine | 7205 Fawn Crossing Dr, Clarksville, MD 21029-1743 | 2007-04-04 |
| 1780709451 | Gateway Medical Associates, P.C. | Internal Medicine | 751 Chesapeake Lane, Ste 101, Clarksville, TN 37040-5263 | 2007-03-20 |
| 1831274117 | Olawumi Olubukola Ayo | Internal Medicine | 1771 Madison Street, Clarksville, TN 37043-4990 | 2006-10-26 |
| Find all providers in CLARKSVILLE | ||||
| City | CLARKSVILLE |
| Zip Code | 21029 |
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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.