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PREMIER PHYSICIAN GROUP LLC NPI 1801064704


NPI Information

NPI: 1801064704
Provider Name: PREMIER PHYSICIAN GROUP, LLC
Classification: Surgery - 208600000X
Entity Type: Organization
Address:
6430 ROCKLEDGE DRIVE
SUITE 470
BETHESDA, MD
ZIP 20817
Phone: (301) 896-6931
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PREMIER PHYSICIAN GROUP, LLC is a surgery in Bethesda, MD. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. PREMIER PHYSICIAN GROUP, LLC NPI is 1801064704. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

6430 ROCKLEDGE DRIVE
SUITE 470
BETHESDA, MD
ZIP 20817
Phone: (301) 896-6931
Fax: (301) 581-0077

The provider's authorized official is Matthew G Poffenroth .
The authorized official title is President / Ceo and has the following contact phone number (301) 896-6900.

The enumeration date for this NPI number is 2/13/2008 and was last updated on 11/13/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1231H00000XAudiologistNo
2207R00000XInternal MedicineNo
3207Y00000XOtolaryngologyNo
4208C00000XColon & Rectal SurgeryNo
5208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)No
6208M00000XHospitalistNo
7363A00000XPhysician AssistantNo
8363L00000XNurse PractitionerNo
9208600000XSurgeryYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1129500MEDICARE PINDISTRICT OF COLUMBIA
2415096100MEDICAIDMARYLAND

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: 11/14/2023

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