Maryland Healing Waters, LLC
NPI 1366739179 · Internal Medicine Physician · Glen Burnie, MD
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Maryland Healing Waters, LLC is a Internal Medicine Physician organization in Glen Burnie, MD (NPI 1366739179).
Provider details
- NPI number
- 1366739179
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Lawrence Vidaver, Physician(410) 761-7901
- License
- D25559 (MD)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
14 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
Mailing address
Registry dates
- Enumerated
- 2011-06-30
- Last updated
- 2024-05-17
- Certified
- 2024-05-17
Frequently asked questions
- What is Maryland Healing Waters, LLC's NPI number?
- Maryland Healing Waters, LLC's National Provider Identifier (NPI) is 1366739179, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Maryland Healing Waters, LLC?
- Maryland Healing Waters, LLC is classified in the NPPES registry as Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Maryland Healing Waters, LLC located?
- Maryland Healing Waters, LLC's practice location on file with NPPES is 1414 Crain Hwy N Ste 6a, Glen Burnie, MD 21061-9307.
- What is Maryland Healing Waters, LLC's phone number?
- The practice phone number listed in the NPPES registry for Maryland Healing Waters, LLC is (410) 761-7901.
- Does Maryland Healing Waters, LLC accept Medicare?
- Maryland Healing Waters, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Maryland Healing Waters, LLC?
- The authorized official listed on Maryland Healing Waters, LLC's NPPES record is Lawrence Vidaver, Physician. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Maryland Healing Waters, LLC's NPI active?
- Yes — Maryland Healing Waters, LLC's NPI (1366739179) is active in the NPPES registry as of the last update on 2024-05-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.