OrganizationActive
Atlantic General Hospital Corporation
NPI 1063230605 · Pediatrics Physician · Berlin, MD
Provider details
- NPI number
- 1063230605
- Entity type
- Organization
- Primary specialty
- Pediatrics PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Atlantic General Hospital Corporation
- Organization subpart
- Yes
- Authorized official
- Stephanie Gary, Svp, Finance/Cfo of Tidalhealth(410) 912-6059
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Nurse Practitioner363L00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(56/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10614 Racetrack Rd Unit 1
Berlin, MD 21811-3383
Phone: (443) 728-1004
Street-level locationGet directions
Mailing address
9733 Healthway Dr
Berlin, MD 21811-1156
Other names (DBA / former)
- Doing business as
- Atlantic General Health System
- Doing business as
- Atlantic General Health System
Registry dates
- Enumerated
- 2024-10-02
- Last updated
- 2025-05-30
- Certified
- 2025-05-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.