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MODERN DERMATOLOGY OF MARYLAND, LLC
NPI 1619605078
Dermatology in Annapolis, MD

Active since August 12, 2022CLIA 21D2279618 · Certificate of Compliance
2568A RIVA RD STE 102, ANNAPOLIS, MD 21401(410) 216-0993 Get Directions Write a Review

NPPES record last updated: December 3, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 3, 2024, Mar 1, 2023, Feb 12, 2023 and 1 more (4 updates tracked since 2022).

About Modern Dermatology Of Maryland, Llc NPPES

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

MODERN DERMATOLOGY OF MARYLAND, LLC (NPI 1619605078) is a healthcare organization registered as a dermatology in Annapolis, Maryland and active in the NPI registry since August 2022. The organization holds a CLIA Certificate of Compliance certificate valid through March 7, 2028 and lists Lane Alexander Neidig, Managing Member, as its authorized official.

NPPES Registry Identity

NPI1619605078
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameMODERN DERMATOLOGY OF MARYLAND, LLC
Location Address2568A RIVA RD STE 102Annapolis, MD 21401-7457
Mailing Address2568a Riva Rd Ste 102Annapolis, MD 21401-7457 · (410) 216-0993
Phone(410) 216-0993
Organization SubpartNo
Authorized OfficialLane Alexander NeidigManaging Member · (410) 216-0993
Enumeration DateAugust 12, 2022
Last NPPES UpdateDecember 3, 20244 updates tracked since enumeration
NPPES CertifiedDecember 3, 2024
✔ NPI 1619605078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Also ListedDermatology · MOHS-Micrographic SurgeryTaxonomy 207ND0101X
Also ListedDermatology · DermatopathologyTaxonomy 207ND0900X
Also ListedDermatology · Pediatric DermatologyTaxonomy 207NP0225X
Also ListedDermatology · Procedural DermatologyTaxonomy 207NS0135X
2568A RIVA RD STE 102, Annapolis, MD 21401
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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 MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 21D2279618

Modern Dermatology Of Maryland LLC · Annapolis, MD
Active · expires Mar 7, 2028
CLIA Number21D2279618
Laboratory TypePhysician Office
Certificate Effective DateMarch 8, 2026
Certificate Expiration DateMarch 7, 2028
Laboratory DirectorLane Neidig
Laboratory Phone(410) 216-0993
Laboratory LocationModern Dermatology Of Maryland LLC2568A Riva Road Suite 102, Annapolis, MD 21401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 2

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

CARA ELIZABETH ARCIDIACONO PA-C
Physician Assistant
2568A RIVA RD STE 102
ANNAPOLIS, MD 21401
Anne Arundel County (410) 216-0993
LANE NEIDIG MD
Dermatology
2568A RIVA RD STE 102
ANNAPOLIS, MD 21401
Anne Arundel County (410) 216-0993

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 Modern Dermatology Of Maryland, LLC's NPI number?

The NPI number for Modern Dermatology Of Maryland, LLC is 1619605078. It was assigned to this organization in the NPPES registry on August 12, 2022.

Where is Modern Dermatology Of Maryland, LLC located?

Modern Dermatology Of Maryland, LLC is located at 2568A Riva Rd Ste 102, Annapolis, MD 21401. The listed phone number is (410) 216-0993.

What is Modern Dermatology Of Maryland, LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Modern Dermatology Of Maryland, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 21D2279618) is associated with this NPI, valid through March 7, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Modern Dermatology Of Maryland, LLC was last updated on December 3, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.