Provider Demographics
NPI:1912966268
Name:MACLAUGHLIN, EDMUND JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:JOHN
Last Name:MACLAUGHLIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 DUTCHMANS LN STE A3
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4302
Mailing Address - Country:US
Mailing Address - Phone:410-819-6545
Mailing Address - Fax:410-819-6750
Practice Address - Street 1:505 DUTCHMANS LN STE A3
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4302
Practice Address - Country:US
Practice Address - Phone:410-819-6545
Practice Address - Fax:410-819-6750
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD28209207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD260511200Medicaid
D76277Medicare UPIN