ACCESS TO THIS SYSTEM IS RESTRICTED TO AUTHORIZED USERS ONLY AND LIMITED TO APPROVED BUSINESS PURPOSES. BY USING THIS SYSTEM, YOU EXPRESSLY CONSENT TO THE MONITORING OF ALL ACTIVITIES. ANY UNAUTHORIZED ACCESS OR USE OF THIS SYSTEM IS PROHIBITED AND COULD BE SUBJECT TO CRIMINAL AND CIVIL PENALTIES. ALL TRANSACTIONAL RECORDS, REPORTS, EMAILS, SOFTWARE, AND OTHER DATA GENERATED OR RESIDING UPON THIS SYSTEM ARE THE PROPERTY OF THE STATE OF MARYLAND.

Provider Registration

   

Please choose a UserName that contains 6 to 12 characters. No special characters allowed.

   
   
*First Name

Same first name as registered with certifying Board, such as the Maryland Board of Physicians.

Middle Name
*Last Name

Same last name as registered with certifying Board, such as the Maryland Board of Physicians.

Suffix
*Last four digits of SSN
*Date of Birth
RadDatePicker
RadDatePicker
Open the calendar popup.

Click on Calendar popup or enter date (mm/dd/yyyy)

   

Password Rules:
1.Must be at least 8 characters
2.Must contain at least one lower case letter, one upper case letter, one digit and one special character
3.Valid special characters are - @#$%^!&+=<>'

Maryland Office Address


*Address1
Address2
*City
*County
State MD
*Zip
*Phone

NOTICE:

MMCC publishes the names, office addresses and phone numbers of registered providers on its website. You may choose to not have your contact information published on the website, however, the names, office addresses and phone numbers of all registered providers, regardless of the answers provided below, will be included in any Public Information Act request for registered providers.

Please indicate whether or not you want to be included in the list on the website by your answers below:

Please include my contact information on the MMCC website:  

I am currently accepting new patients:  

Provider

*Controlled Dangerous Substances (CDS) Registration Number Click here to access Controlled Dangerous Substances (CDS) System.
*I am licensed by  
*Select Medical Conditions for which written certificates will be issued
I attest that my Maryland license to practice medicine is active, unrestricted and in good standing.
I attest that I am registered to prescribe controlled substances by the State.
I hereby certify that before issuing a written certificate I will have a bona fide provider-patient relationship with the qualifying patient and will perform a full in-person assessment on a yearly basis.
I hereby certify that I have not received compensation, including promotion, recommendation, advertising, or anything of value from a licensed grower or dispensary (unless otherwise approved by the Commission).
I declare and affirm under penalty of perjury that the statements made herein are true and correct to the best of my knowledge, information and belief.