Healthcare Provider Details
I. General information
NPI: 1265275010
Provider Name (Legal Business Name): CLEARWAY SURGERY CENTER OF DOVER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/18/2024
Last Update Date: 06/18/2024
Certification Date: 06/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
655 S BAY RD STE 3D
DOVER DE
19901-4659
US
IV. Provider business mailing address
201 DEFENSE HWY STE 205
ANNAPOLIS MD
21401-7096
US
V. Phone/Fax
- Phone: 855-527-7246
- Fax: 866-229-5063
- Phone: 855-527-7246
- Fax: 866-229-5063
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DAMEAN
FREAS
Title or Position: CEO
Credential: DO
Phone: 443-852-5483