Organization · Type 2 NPI

Civista Clinical Sercives, LLC

Neurology Physician · La Plata, MD

NPI number 1619237344 Active

Practice location

101 Centennial St, Suite B
La Plata, MD 20646-5975

Call (301) 609-4539 Map

Mailing address

75 Remittance Dr Dept 6554
Chicago, IL 60675-6554

Specialties and licenses

Taxonomy	Code	License
Neurology Physician Primary	2084N0400X	None listed

Neurology Physician: A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

9 other providers at this address

NPI record

NPI: 1619237344
Entity type: Organization (Type 2)
Issued: May 29, 2012
Last updated: Jun 12, 2014
Status: Active
Subpart: Yes of University of Maryland Charles Regional Medical Group

Other names

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University of Maryland Charles Regional Neurology Center · other name

Authorized official

Stephanie Simm
Physician Relations Specialist
(301) 609-4539

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1619237344

Civista Clinical Sercives, LLC's National Provider Identifier is 1619237344, issued on May 29, 2012. The primary taxonomy on file is Neurology Physician (2084N0400X), and the practice location is in La Plata, MD. The record was last updated on Jun 12, 2014.