Healthcare Provider Details

I. General information

NPI: 1265366504
Provider Name (Legal Business Name): CAPITAL HARBOR SURGERY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8222 SCHULTZ RD STE 100B
CLINTON MD
20735-2607
US

IV. Provider business mailing address

8222 SCHULTZ RD STE A100
CLINTON MD
20735-2606
US

V. Phone/Fax

Practice location:
  • Phone: 202-221-8442
  • Fax: 202-221-8443
Mailing address:
  • Phone: 202-221-8442
  • Fax: 202-221-8443

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMAECHI ERONDU
Title or Position: OWNER
Credential: MD
Phone: 443-414-1139