Healthcare Provider Details

I. General information

NPI: 1841668647
Provider Name (Legal Business Name): CEDAR TREE SURGICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2015
Last Update Date: 09/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

379 WALMART DR
CAMDEN DE
19934-1365
US

IV. Provider business mailing address

PO BOX 428
ELKTON MD
21922-0428
US

V. Phone/Fax

Practice location:
  • Phone: 302-698-4441
  • Fax: 302-595-3149
Mailing address:
  • Phone: 410-398-0590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ZAHID ASLAM
Title or Position: MANAGING MEMBER
Credential:
Phone: 302-698-4441