Maryland Board of Physicians
Practitioner Profile Portal
This data was extracted on
9/30/2025
.
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License Number
:
C0007402
Kelsey Smith McGillivray
License Type
:
Physician Assistant
License Status
:
Active
License Issued
:
11/01/2019
License Expiration:
06/30/2027
Licensure Pathway:
Traditional
Special License Category:
N/A
Education
N/A
Medical Assistance
Accept Medicaid?
Yes
Maryland Hospital Privilege Information
(as reported by licensee)
Medstar Southern Maryland Hospital Center
Medical Licenses Held in Other States
(as reported by licensee)
District of Columbia
Virginia
Physician Assistant Notification of Collaboration Agreements
Collaboration Agreements have not been reported for the profile site.
Active Supervisee - Delegation Agreement For Core Duties
D0038543
Kevin Henry Scruggs Status: Approved |
Approved Date:
08/19/2021 | Agreement No: 22563
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
D0093306
Samer Jabbour Status: Approved |
Approved Date:
07/31/2024 | Agreement No: 34701
Prescribe CDS: Yes | Non-CDS: Yes | Medical Devices: Yes
Dispense CDS: No | Dispense NCDS: No
Download all Maryland Disciplinary Actions
(not time-limited)
All Orders are downloaded in .pdf format.
None.
Summary of Known Disciplinary Actions by any state medical board
(within the past 10 years)
Please Read Description
In Maryland:
No Known Disciplinary Actions by the Maryland Board of Physicians have been reported.
Other States:
No Known Disciplinary Actions by any other state medical board have been reported.
Pending Charges
Please Read Disclaimer
All Charges are downloaded in .pdf format.
None.
Other Public Actions in the Practice of the Profession or Administrative Fines
(including Maryland)
Please Read Description
No reported Other Public Actions in the Practice of the Profession or Administrative Fines (incl. Maryland) for this licensee.
Convictions for any crime involving moral turpitude
None reported by the courts.
Appendix
General Disclaimer
Glossary of Terms
Notice to Credential Verification Professionals