MEDICARE: WATKINS MILL ASC LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1477446326
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WATKINS MILL ASC LLC

Provider Business Mailing Address
First Line	:	6707 DEMOCRACY BLVD STE 504
Second Line	:
City	:	BETHESDA
State	:	MD
Zip	:	20817-1166
Country	:	US
Telephone Number	:	240-743-3524
Fax Number	:	240-743-3524

Provider Business Practice Location Address
First Line	:	55 W WATKINS MILL RD STE 250
Second Line	:
City	:	GAITHERSBURG
State	:	MD
Zip	:	20878-4021
Country	:	US
Telephone Number	:	240-751-1951
Fax Number	:	240-751-1951

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	LATANYA STRICKLAND
Credential	:
Telephone Number	:	240-743-3524

Provider Enumeration Date	:	05/30/2025
Last Update Date	:	04/21/2026

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