GENERAL APPLICATION INFORMATION
ONLINE LICENSE RENEWAL

Failure to renew and pay for your license by September 30, 2008 will result in a late fee of $100.00. To avoid a late fee submit your application and $518.00 before September 30, 2008.
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ONLINE RENEWAL INFORMATION

  • Your address(es) on the online renewal application is current as of July 1, 2008. If you requested any changes to your address(es) that are not reflected on this application, please make the change at this time. These changes will be updated in the main database.
  • The electronic application is divided into sections for ease of use. You may select which section to complete.
  • You may leave the application and return at a later time to review or complete your application. The information you have entered will be saved.
  • You will need the following information to complete this application:

    Medical License Number
    Employer Tax Number (EIN)
    National Provider Identifier (NPI) number, if available
    Workman's Compensation carrier name, policy number, and expiration date-only if you employ one or more individuals in your practice
    General office information (address, telephone and fax numbers)
    Access to a printer to print a copy of your completed renewal application and your license confirmation receipt.

  • Please complete a short evaluation questionnaire. This helps us make changes to the site to meet your requests.
  • The Maryland Board of Physicians is collecting information on how best to contact you if there is a catastrophic health emergency. Please complete the Physician Emergency Contact Information section before you submit your application.
  • You will have the option of making a payment of the license fee by Visa or Mastercard. You will receive your receipt immediately, no mailing is required.
  • You will also have the option of paying the license fee by check or by designating the applicant's employer or third party as the payer and paying by check. If payment is being mailed, either by the individual, the employer, or the third party, your license will not be renewed until the fee, including any applicable late fee, is received by the Board.
  • If you elect not to pay by credit card, an electronic invoice will be available to print out to include with your payment. Please print out the invoice and attach to your check or check from employer/third party. FAILURE TO DO SO MAY DELAY THE RENEWING OF YOUR LICENSE.
  • You will be required to affirm your responses on the application.

Security Notice

This renewal site is secured by the use of HTTPS software and VeriSign Digital Trust Services. It encrypts the data transmission to and from your PC to prevent unauthorized viewing of information that is entered, including the credit card information. It also authenticates the internet connection between your PC and our web site.

Additional Instructions

1. Physicians with last names beginning with the letters A through L must renew their licenses by September 30, 2008.

2. The fee for renewal is $518.00; this fee includes support for the Physician Rehabilitation Program, peer review services, and $32 which Maryland law requires that the Board collect and forward to the Maryland Health Care Commission.

3. Your check or money order for $518.00 should be made payable to the Maryland Board of Physicians. WRITE YOUR PHYSICIAN'S LICENSE NUMBER ON THE CHECK OR MONEY ORDER. Credit card payments are only accepted online.

4. If not paying by credit card, mail your invoice and total fee of $518.00 to:
Maryland Board of Physicians
P.O. Box 17314
Baltimore, MD 21297-0475

The U.S. Post Office will accept any category of U.S. mail to the P.O. Box. The Post Office does NOT accept mail addressed to a post office box from delivery services such as Airborne, Fed Ex, or U.P.S. Do not hand-deliver your application to the Board office. Any application received directly by the Board will be sent to the post office box; this will delay the process.

5. Complete the online application and pay the proper fee by September 30, 2008. If you completed your application online but chose to pay by check, your payment must be received by or postmarked on or before September 30, 2008, or your application will be subject to a $100 late fee. If the payment is postmarked September 30th, but is not received by the Board until after that date, the license is not renewed until the Board receives and processes your payment. It will take at least 7 days for the Board to receive your payment. You may not practice if your license has not been renewed.

Late Renewals: A late fee of $100 will be applied to any application not completed by 12:00 midnight (EST) on September 30, 2008. Your late renewal aplication must be complete and proper fees must be received or postmarked on or before November 30, 2008. You are not authorized to practice medicine in Maryland until your license has been renewed.

6. Question 1: Enter your physician's license number with two leading zeroes after the letter prefix.

7. Question 2: Enter your name as it is on your physician's license. Do not make any name changes on this form.

8. Question 3: Enter changes to either your public or your non-public address. The public address appears on your profile, which is available at the Board's website on the Internet. The non-public address is confidential and is used by the Board to correspond with you. You may provide a public address; if you provide only a non-public address, this address will also be made available to the public.

9. Question 4: Disclosure of date of birth: Please indicate whether the Board may disclose your date of birth to the Federation of State Medical Boards' Physician Data Center .

10. Question 6: You must answer all parts of question 6, regarding character and fitness. If you answer "yes" to any question, you must attach an explanation to your application. The explanation must include your printed name, license number, your signature, and the date. Do not attach correspondence to this renewal application unless it concerns your explanation to a "Yes" answer to question number 6.

11. Question 7: Continuing Medical Education: Choose the statement which applies to you.

  • Select "a" to certify that you have earned at least 50 credit hours of Category 1 CME within the two years preceding this application. You are required to obtain documentation of CME attendance and retain this documentation for the succeeding six years for possible inspection by the Board. (Health Occupations, §14-316 (d); COMAR 10.32.01.09)
  • Select "b" if this is your first renewal after licensure in Maryland. You are not required to complete continuing medical education (CME) credits. However, you must have completed the New Physician Orientation Program before you will be renewed. If you need to complete the New Physician Orientation Program, please go to our website at http://www.mbp.state.md.us and complete the program now. Your license will not be renewed until you have completed the orientation.
  • Select "c" if this is your first renewal after reinstatement of your Maryland license. You are not required to meet the CME requirement.

12. Question 32: Affirmation and signature: Read the affirmation, sign your application, and indicate the date signed. Your license will not be renewed unless all questions are answered and the renewal application has been signed. Please insert your license number in the blocks below the date line.

13. Question 33: Physician Emergency Contact Information: As part of Maryland's emergency preparedness efforts, the Department of Health and Mental Hygiene has identified the need for contact information on licensed physicians in Maryland. Please include this information on the page headed "Physician Emergency Contact Information." (Public Safety Article, Section 14-3A-01 et seq. and Health General Article, §18-901 et seq. set forth the powers of the Governor and Secretary of the Department of Health and Mental Hygiene.)



Additional Information for Physicians

1. The information on the renewal application will allow:

  1. The Board to identify physicians and process reports efficiently;
  2. The Maryland Health Care Commission (MHCC) to identify physician primary care shortages and to relate specialty to health claim data and provide annual reports;
  3. Debt repayment under the Physician Loan Assistance Repayment Program and distribution of funds to higher educa tion institutions under the Health Manpower Shortage Incentive Grant Program;
  4. MHCC to propose designations of federal Health Professional Shortage Areas.
    (Law and regulations relevant to these items can be found in Health Occupations Article, §14-207; Health General Article §§ 19-115 and 19-133; Education Article §18-803; 42CFR Part 5)

2. This form also includes information for the Health Care Alternative Dispute Resolutions. Maryland law states: "Every physician who is licensed to practice medicine in the State, and who is a resident of the State, shall be available to serve as an arbitrator of health care malpractice claims." (Courts and Judicial Proceedings, §3-2A-03)

3. Options Available to Physicians with Active Licenses

  1. Renewal of license: Renew your license online or send the completed forms and check in the amount of $518.00 payable to the Maryland Board of Physicians, by September 30, 2008 (or a check in the amount of $618.00 by November 30, 2008 for late renewal).
  2. Exemption from license fee: If you will be providing medical services to patients without personal remuneration, will not be engaged in the private practice of medicine, and will not write prescriptions for yourself, your family, or your friends, you may qualify for exemption from license fee. You must obtain an "Application for Exemption from License Fees" form (available at www.mbp.state.md.us) and follow the directions on that form.
  3. Voluntary non-renewal of license: If you will not be practicing medicine at all after September 30, 2008, you may elect not to renew your license. If you do not want to renew your license, you do not need to do anything with this renewal application. If you wish to practice in Maryland in the future, you will be required to reinstate your license.
  4. Inactive Status: If you will not practice medicine in Maryland after September 30, 2008 but wish to place your license on "Inactive Status", you may apply during the renewal period and pay a $50 fee. Obtain an inactive status application from the Board's website at www.mbp.state.md.us. Complete the application and mail it, with a check or money order for $50 payable to the Maryland Board of Physicians. Deadline for submission is November 30, 2008. Holders of inactive licenses will receive the MBP Newsletter for two years at no charge. You may not practice medicine, prescribe medication, or conduct peer reviews of other physi cians if your license status is inactive. If you wish to practice in Maryland in the future, you will be required to reinstate your license.

4. Name Change: If you wish to change the name on your medical license, you must obtain an "Application for Physician Name Change" form and follow the directions. Name changes shown on this form will not change your record but may delay your renewal.

5. Mandatory disclosure of date of birth to Board: In order to comply with federal statute, the Maryland Board of Physicians is obligated to inform each applicant or licensee for whom it requests a date of birth that disclosing such a number is mandatory in order to comply with the requirements of the National Practitioners Data Bank and the Healthcare Integrity and Protection Data Bank. If this Board is required to make a report about one of its applicants or licensees to either of these data banks, it must report that individual's date of birth.

Voluntary disclosure of date of birth to Federation: Sending your date of birth to the Federation of State Medical Boards is voluntary. The Center compiles information about individual applicants and licensees and transmits that information to other licensing boards in order to coordinate licensure and disciplinary activities between the individual states.

6. Practicing Without a License: Any person who practices medicine without a license is subject to a civil fine of not more than $50,000 to be levied by the Board. (Health Occupations Article, §§14-601, 606)