Provider Demographics
NPI:1942492111
Name:EDMUND J. MACLAUGHLIN, MD, LLC
Entity type:Organization
Organization Name:EDMUND J. MACLAUGHLIN, MD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:MACLAUGHLIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-228-0556
Mailing Address - Street 1:505 DUTCHMANS LN STE A3
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:MD
Mailing Address - Zip Code:21601-4302
Mailing Address - Country:US
Mailing Address - Phone:410-819-6630
Mailing Address - Fax:410-819-6646
Practice Address - Street 1:505 DUTCHMANS LN STE A3
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MD
Practice Address - Zip Code:21601-4302
Practice Address - Country:US
Practice Address - Phone:410-819-6545
Practice Address - Fax:410-819-6750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-13
Last Update Date:2022-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD28209207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD260511200Medicaid
922MMedicare PIN