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

Modern Dermatology of Maryland, LLC

Organization Dermatology Physician · NPI 1619605078

Modern Dermatology of Maryland, LLC is a Dermatology Physician in Annapolis, Maryland. Registered with an NPI since 2022.

In the registry since
2022
Specialties on file
5
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

2568A Riva Rd Ste 102
Annapolis, MD 21401-7457
Phone: (410) 216-0993
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X
MOHS-Micrographic Surgery Physician Taxonomy 207ND0101X
Dermatopathology Physician Taxonomy 207ND0900X
Pediatric Dermatology Physician Taxonomy 207NP0225X
Procedural Dermatology Physician Taxonomy 207NS0135X

Record details

NPI number1619605078
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lane Neidig — Managing Member · (410) 216-0993
NPI enumeratedAugust 12, 2022
Last updated in NPPESDecember 3, 2024
Certification dateDecember 3, 2024
Mailing address2568a Riva Rd Ste 102, Annapolis, MD 21401-7457

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