Healthcare Provider Details

I. General information

NPI: 1528680865
Provider Name (Legal Business Name): MERIDIAN SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2020
Last Update Date: 09/26/2022
Certification Date: 09/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19638 LEITERSBURG PIKE STE 205
HAGERSTOWN MD
21742-1515
US

IV. Provider business mailing address

1000 TAVERN RD STE 300
MARTINSBURG WV
25401-2853
US

V. Phone/Fax

Practice location:
  • Phone: 304-263-6165
  • Fax:
Mailing address:
  • Phone: 304-263-6165
  • Fax: 304-263-6563

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: WAHEED S BAKSH
Title or Position: OWNER
Credential: MD, DPT
Phone: 845-325-6504