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Medstar Medical Group - Southern Maryland LLC

Ambulatory Surgical Clinic/Center in Waldorf, MD · enumerated 2015 · authorized official Eric Wagner, Executive Vice President.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1730571118

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Registry record

Entity type Organization (Type 2)
Legal business name Medstar Medical Group - Southern Maryland LLC
Practice address 10 St. Patrick'S Drive, Waldorf, MD, 20603
Fax (301) 373-6900
Enumeration date Feb 23, 2015
Last updated in NPPES May 29, 2026

Taxonomy & classification

261QA1903X Ambulatory Surgical Clinic/Center Ambulatory Health Care Facilities · License A1234 (MD) Primary

Authorized official

Name Eric Wagner
Title Executive Vice President

Other identifiers

Identifier Type State Issuer
423411100 Medicaid MD -
423411103 Medicaid MD -

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.
What type of organization is Medstar Medical Group - Southern Maryland LLC?
Medstar Medical Group - Southern Maryland LLC is registered in NPPES as a Ambulatory Surgical Clinic/Center (its primary provider taxonomy).

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-05-29.