Provider Demographics
NPI:1821621707
Name:MONTGOMERY COUNTY MARYLAND GOVERNMENT
Entity Type:Organization
Organization Name:MONTGOMERY COUNTY MARYLAND GOVERNMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EHR PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SOMMER
Authorized Official - Middle Name:MARTINE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-777-1643
Mailing Address - Street 1:19401 CRYSTAL ROCK DR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1593
Mailing Address - Country:US
Mailing Address - Phone:301-353-8010
Mailing Address - Fax:
Practice Address - Street 1:19401 CRYSTAL ROCK DR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1593
Practice Address - Country:US
Practice Address - Phone:301-353-8010
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty