Healthcare Provider Details

I. General information

NPI: 1558876367
Provider Name (Legal Business Name): PARK CENTER SURGICAL CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2017
Last Update Date: 12/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14201 PARK CENTER DR STE 408
LAUREL MD
20707-5251
US

IV. Provider business mailing address

14201 PARK CENTER DR STE 408
LAUREL MD
20707-5251
US

V. Phone/Fax

Practice location:
  • Phone: 301-498-0383
  • Fax: 240-712-5052
Mailing address:
  • Phone: 301-498-0383
  • Fax: 240-712-5052

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: DR. RISHI BHATNAGAR
Title or Position: SOLE OWNER
Credential: MD
Phone: 301-498-0383