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GEORGE H WATHEN MD PA
NPI 1710168836
Specialist in Waldorf, MD

Active since November 16, 2007CLIA 21D1010496 · Microscopy
SUITE 103, 11345 PEMBROOKE SQ, WALDORF, MD 20603(301) 645-8144(301) 870-8392 Get Directions Write a Review

NPPES record last updated: February 15, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About George H Wathen Md Pa NPPES

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

GEORGE H WATHEN MD PA (NPI 1710168836) is a healthcare organization registered as a specialist in Waldorf, Maryland and active in the NPI registry since November 2007. The organization holds a CLIA Microscopy certificate valid through June 28, 2028 and lists George H Wathen, President, as its authorized official.

NPPES Registry Identity

NPI1710168836
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameGEORGE H WATHEN MD PA
Location AddressSUITE 103, 11345 PEMBROOKE SQWaldorf, MD 20603-4804
Mailing Address11345 Pembrooke Sq, Suite 103Waldorf, MD 20603-4804 · (301) 645-8144 · Fax (301) 870-8392
Phone(301) 645-8144
Fax(301) 870-8392
Organization SubpartNo
Authorized OfficialGeorge H WathenPresident · (301) 645-8144
Enumeration DateNovember 16, 2007
Last NPPES UpdateFebruary 15, 2008
✔ NPI 1710168836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in MD · D0020629
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
SUITE 103, Waldorf, MD 20603
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Other Identifiers 4

OtherDG5923R R Medicare
Medicare PING02195DC
Medicare PIN223N239GMD
Medicare UPINE21315

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 for Provider-Performed Microscopy Procedures (PPMP) 21D1010496

George H Wathen MD Facp · Waldorf, MD
Active · expires Jun 28, 2028
CLIA Number21D1010496
Laboratory TypePhysician Office
Certificate Effective DateJune 29, 2026
Certificate Expiration DateJune 28, 2028
Laboratory DirectorGeorge H. Wathen MD
Laboratory Phone(301) 645-8144
Laboratory LocationGeorge H Wathen MD Facp11345 Pembrooke Square Ste 103, Waldorf, MD 20603
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 George H Wathen MD PA's NPI number?

The NPI number for George H Wathen MD PA is 1710168836. It was assigned to this organization in the NPPES registry on November 16, 2007.

Where is George H Wathen MD PA located?

George H Wathen MD PA is located at Suite 103 11345 Pembrooke Sq, Waldorf, MD 20603. The listed phone number is (301) 645-8144.

What is George H Wathen MD PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does George H Wathen MD PA hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 21D1010496) is associated with this NPI, valid through June 28, 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 George H Wathen MD PA was last updated on February 15, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.