PRIME MD LLC NPI 1558540161

NPI Information

  • NPI: 1558540161
  • Provider Name: PRIME MD LLC
  • Classification: Internal Medicine - 207R00000X
  • Entity Type: Organization
  • CLIA Number: 21D1016590
  • Address: 5005 SIGNAL BELL LN
    SUITE 202
    CLARKSVILLE, MD
    ZIP 21029
  • Phone: (443) 535-8500

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NPI Details

PRIME MD LLC is an internal medicine in Clarksville, MD. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. PRIME MD LLC NPI is 1558540161. The provider is registered as an organization entity type.

The provider's business location address is:

5005 SIGNAL BELL LN
SUITE 202
CLARKSVILLE, MD
ZIP 21029-606
Phone: (443) 535-8500
Fax: (410) 531-1446

The provider's authorized official is Suzan Khalil Abdo .
The authorized official title is Owner/physician and has the following contact phone number (443) 535-8500.

The CLIA number assigned to this NPI record is 21D1016590 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/31/2007 and was last updated on 9/16/2010.

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
1320800000XCommunity Based Residential Treatment Facility, Mental IllnessD50870MARYLANDNo
2320800000XCommunity Based Residential Treatment Facility, Mental IllnessD046855MARYLANDNo
3207R00000XInternal MedicineD0050878MARYLANDYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G66525MEDICARE UPINMARYLAND
2=========OTHERMARYLANDTRICARE
3G38319MEDICARE UPINMARYLAND
4198MMEDICARE PINMARYLAND
5F698OTHERDISTRICT OF COLUMBIABSDC
6MD198MMEDICARE PINMARYLAND

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: 11/21/2025

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