OrganizationActive
Old Line Medical Services, P.C.
NPI 1164580635 · Health Service Clinic/Center · Waldorf, MD
Provider details
- NPI number
- 1164580635
- Entity type
- Organization
- Primary specialty
- Health Service Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Stephen Wiggins, President(301) 843-3888
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs 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
12090 Old Line Ctr
Waldorf, MD 20602-2556
Phone: (301) 843-3888
Fax: (301) 870-6838
Approximate (ZIP-level) locationGet directions
Mailing address
12090 Old Line Ctr
Waldorf, MD 20602-2556
Other names (DBA / former)
- Doing business as
- Convenient Health Care
Registry dates
- Enumerated
- 2006-12-05
- Last updated
- 2010-07-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.