Healthcare Provider Details
I. General information
NPI: 1639983711
Provider Name (Legal Business Name): SURGICAL ASSOCIATES CHARTERED
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/06/2025
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1160 VARNUM ST NE STE 318
WASHINGTON DC
20017-2103
US
IV. Provider business mailing address
5801 ALLENTOWN RD STE 502
CAMP SPRINGS MD
20746-4653
US
V. Phone/Fax
- Phone: 240-427-1630
- Fax:
- Phone: 240-427-1630
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RODEEN
RAHBAR
Title or Position: PRESIDENT
Credential:
Phone: 240-427-1630