Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Civista Clinical Services, LLC

Organization Otolaryngology Physician · NPI 1710247440

Civista Clinical Services, LLC is an Otolaryngology Physician in LA Plata, Maryland. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

500 Charles St
LA Plata, MD 20646-5931
Phone: (301) 609-4539
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X
Otolaryngology Physician Taxonomy 207Y00000X
Vascular Surgery Physician Taxonomy 2086S0129X

Record details

NPI number1710247440
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationCivista Clinical Services, LLC
Authorized official Stephanie Simm — Physician Relations Specialist · (301) 609-4539
Other names La Plata Surgical Care
NPI enumeratedMay 29, 2012
Last updated in NPPESJune 12, 2014
Mailing address75 Remittance Dr Dept 6554, Chicago, IL 60675-6554