Healthcare Provider Details

I. General information

NPI: 1164548996
Provider Name (Legal Business Name): ROCKVILLE AMBULATORY SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W EDMONSTON DR
ROCKVILLE MD
20852-1228
US

IV. Provider business mailing address

50 W EDMONSTON DR
ROCKVILLE MD
20852-1228
US

V. Phone/Fax

Practice location:
  • Phone: 301-340-8666
  • Fax: 301-340-7448
Mailing address:
  • Phone: 301-340-8666
  • Fax: 301-340-7448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA1154
License Number StateMD

VIII. Authorized Official

Name: DR. MARTIN CHARLES FLAUM
Title or Position: OWNER
Credential: DPM
Phone: 301-340-8666