MONTGOMERY DERMATOLOGY ASSOCIATES LLC NPI 1083012355

NPI Information

  • NPI: 1083012355
  • Provider Name: MONTGOMERY DERMATOLOGY ASSOCIATES, LLC
  • Classification: Clinic/Center - 261QM2500X
  • Specialization: Medical Specialty
  • Entity Type: Organization
  • Address: 15225 SHADY GROVE RD
    STE. 303
    ROCKVILLE, MD
    ZIP 20850
  • Phone: (301) 216-2980

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NPI Details

MONTGOMERY DERMATOLOGY ASSOCIATES, LLC is a medical specialty clinic center in Rockville, MD. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). MONTGOMERY DERMATOLOGY ASSOCIATES, LLC NPI is 1083012355. The provider is registered as an organization entity type.

The provider's business location address is:

15225 SHADY GROVE RD
STE. 303
ROCKVILLE, MD
ZIP 20850-254
Phone: (301) 216-2980
Fax: (301) 216-2982

The provider's authorized official is Walter J Giblin .
The authorized official title is Member / Owner and has the following contact phone number (301) 216-2983.

The enumeration date for this NPI number is 12/18/2014 and was last updated on 12/18/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM2500XClinic/CenterMedical SpecialtyD0042867MARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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