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SOUTH RIVER PRIMARY CARE LLC
NPI 1154548303
Family Medicine in Edgewater, MD

Active since April 19, 2007
3168 BRAVERTON ST, SUITE 330, EDGEWATER, MD 21037(410) 956-7830(410) 956-7832 Get Directions Write a Review

NPPES record last updated: July 29, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About South River Primary Care Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTH RIVER PRIMARY CARE LLC (NPI 1154548303) is a healthcare organization registered as a family medicine in Edgewater, Maryland and active in the NPI registry since April 2007. The organization lists Timothy Paul Fry, Owner, as its authorized official.

NPPES Registry Identity

NPI1154548303
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSOUTH RIVER PRIMARY CARE LLC
Location Address3168 BRAVERTON ST, SUITE 330Edgewater, MD 21037-2674
Mailing Address3168 Braverton St, Suite 330Edgewater, MD 21037-2674 · (410) 956-7830 · Fax (410) 956-7832
Phone(410) 956-7830
Fax(410) 956-7832
Organization SubpartNo
Authorized OfficialTimothy Paul FryOwner · (410) 956-7830
Enumeration DateApril 19, 2007
Last NPPES UpdateJuly 29, 2009
✔ NPI 1154548303 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MD · H0056281
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
3168 BRAVERTON ST, Edgewater, MD 21037
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Other Identifiers 1

Medicare UPINH51462MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NADIA AKHMED M.D.
Internal Medicine
3168 BRAVERTON ST, 330
EDGEWATER, MD 21037
Anne Arundel County (410) 956-3090
MS. NICOLE MARIE MASSON PA-C
Physician Assistant
3168 BRAVERTON ST, SUITE 340
EDGEWATER, MD 21037
Anne Arundel County (410) 956-7777
NADIA AKHMED MD INTERNAL MEDICINE LLC
Internal Medicine
3168 BRAVERTON ST, 330
EDGEWATER, MD 21037
Anne Arundel County (410) 956-3090
MACKENZIE DOSHI PA-C
Physician Assistant
3168 BRAVERTON ST, SUITE 340
EDGEWATER, MD 21037
Anne Arundel County (410) 956-7777
MINI BHASKAR MD LLC
Internal Medicine (Rheumatology)
3168 BRAVERTON ST, 330
EDGEWATER, MD 21037
Anne Arundel County (410) 956-3090
SOUTH RIVER AMBULATORY SURGERY
Clinic/Center (Ambulatory Surgical)
3168 BRAVERTON ST, SUITE 310
EDGEWATER, MD 21037
Anne Arundel County (410) 956-7777

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is South River Primary Care LLC's NPI number?

The NPI number for South River Primary Care LLC is 1154548303. It was assigned to this organization in the NPPES registry on April 19, 2007.

Where is South River Primary Care LLC located?

South River Primary Care LLC is located at 3168 Braverton St Suite 330, Edgewater, MD 21037. The listed phone number is (410) 956-7830.

What is South River Primary Care LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for South River Primary Care LLC was last updated on July 29, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.