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

South River Primary Care LLC

Organization Family Medicine Physician · NPI 1154548303

South River Primary Care LLC is a Family Medicine Physician in Edgewater, Maryland. Licensed in Maryland. Registered with an NPI since 2007.

Licensed in
MD
In the registry since
2007
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

3168 Braverton St Ste 330
Edgewater, MD 21037-2674
Phone: (410) 956-7830
Fax: (410) 956-7832
Show map & directions

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

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence H0056281 (MD)

Record details

NPI number1154548303
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Timothy Fry — Owner · (410) 956-7830
NPI enumeratedApril 19, 2007
Last updated in NPPESJuly 29, 2009
Mailing address3168 Braverton St, Suite 330, Edgewater, MD 21037-2674

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