Healthcare Provider Details

I. General information

NPI: 1326974197
Provider Name (Legal Business Name): EO SURGICAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2026
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

306 W REDWOOD ST # 4153
BALTIMORE MD
21201-1708
US

IV. Provider business mailing address

306 W REDWOOD ST # 4153
BALTIMORE MD
21201-1708
US

V. Phone/Fax

Practice location:
  • Phone: 240-531-2184
  • Fax:
Mailing address:
  • Phone: 240-531-2184
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number
License Number State

VIII. Authorized Official

Name: LACHANDA MARIE MILLS
Title or Position: OPERATIONS MANAGER
Credential:
Phone: 585-455-3537