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

South River Internal Medicine, PA

Organization Internal Medicine Physician · NPI 1710131024

South River Internal Medicine, PA is an Internal Medicine Physician in Edgewater, Maryland. Licensed in Maryland. Registered with an NPI since 2008.

Licensed in
MD
In the registry since
2008
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3168 Braverton St Ste 250
Edgewater, MD 21037-2682
Phone: (410) 956-1600
Fax: (410) 956-7900
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence D58166 (MD)

Record details

NPI number1710131024
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Renee Nye — Ama/Front Office Manager · (410) 956-1600
NPI enumeratedNovember 13, 2008
Last updated in NPPESSeptember 2, 2024
Certification dateSeptember 2, 2024
Mailing address3168 Braverton St, Suite 250, Edgewater, MD 21037-2674

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