Healthcare Provider Details

I. General information

NPI: 1669487369
Provider Name (Legal Business Name): GS SURGICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 LOCH RAVEN BLVD POB 106
BALTIMORE MD
21239-2905
US

IV. Provider business mailing address

2400 VELVET RIDGE DR
OWINGS MILLS MD
21117-3030
US

V. Phone/Fax

Practice location:
  • Phone: 410-323-9210
  • Fax: 410-323-9525
Mailing address:
  • Phone: 410-323-9210
  • Fax: 410-323-9525

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JEREMY P WEINER
Title or Position: PRESIDENT
Credential: MD
Phone: 410-323-9210