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NPI Code Detail

MEDICARE: CAPITAL CHILDREN'S SURGICAL CENTER, LLC

MEDICARE: CAPITAL CHILDREN'S SURGICAL CENTER, 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
1261QA1903XAmbulatory Surgical Clinic/Center

General Provider Information

NPI Number : 1659817781
Entity Type Code : Organization
Provider Name (Legal Business Name) : CAPITAL CHILDREN'S SURGICAL CENTER, LLC
Provider Business Mailing Address
First Line : 1220 CARAWAY CT STE 1050
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20774-5338
Country : US
Telephone Number : 301-494-3000
Fax Number : 301-494-3333
Provider Business Practice Location Address
First Line : 1220 CARAWAY CT STE 1050
Second Line :
City : UPPER MARLBORO
State : MD
Zip : 20774-5338
Country : US
Telephone Number : 301-494-3000
Fax Number : 301-494-3333
Authorized Official
Title or Position : BUSINESS MANAGER
Name : JEFFREY WHEELER
Credential :
Telephone Number : 301-494-3000
Provider Enumeration Date : 01/12/2017
Last Update Date : 01/12/2017

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Directions to “CAPITAL CHILDREN'S SURGICAL CENTER, LLC ” Practice Location

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