Provider Demographics
NPI:1285182774
Name:PATIENT FIRST MARYLAND MEDICAL GROUP PLLC
Entity Type:Organization
Organization Name:PATIENT FIRST MARYLAND MEDICAL GROUP PLLC
Other - Org Name:PATIENT FIRST - BOWIE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:H
Authorized Official - Last Name:MORISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-968-5700
Mailing Address - Street 1:5000 COX RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-9263
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:
Practice Address - Street 1:15459 ANNAPOLIS ROAD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1847
Practice Address - Country:US
Practice Address - Phone:240-544-0676
Practice Address - Fax:240-544-0677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-14
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4123410024Medicare NSC
MD325471Medicare PIN