Healthcare Provider Details

I. General information

NPI: 1477446326
Provider Name (Legal Business Name): WATKINS MILL ASC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2025
Last Update Date: 12/29/2025
Certification Date: 12/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W WATKINS MILL RD STE 250
GAITHERSBURG MD
20878-4021
US

IV. Provider business mailing address

6707 DEMOCRACY BLVD STE 504
BETHESDA MD
20817-1166
US

V. Phone/Fax

Practice location:
  • Phone: 240-425-4391
  • Fax:
Mailing address:
  • Phone: 240-425-4391
  • Fax: 240-425-4391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER RAFFO
Title or Position: OWNER
Credential: MD
Phone: 240-912-2206