Healthcare Provider Details
I. General information
NPI: 1942807961
Provider Name (Legal Business Name): VSA SURGERY CENTER OF ABINGDON LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/02/2020
Last Update Date: 09/25/2023
Certification Date: 09/25/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3435 BOX HILL CORPORATE CENTER DR STE H
ABINGDON MD
21009-1204
US
IV. Provider business mailing address
520 UPPER CHESAPEAKE DR STE 306
BEL AIR MD
21014-4375
US
V. Phone/Fax
- Phone: 855-648-9982
- Fax: 443-456-3647
- Phone: 410-879-2006
- Fax: 443-787-4302
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:
ANDRE
BIUCKIANS
Title or Position: PARTNER
Credential: MD
Phone: 410-879-2009