Healthcare Provider Details

I. General information

NPI: 1689850737
Provider Name (Legal Business Name): AMBULATORY GENERAL SURGERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2008
Last Update Date: 01/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9715 MEDICAL CENTER DR STE 435
ROCKVILLE MD
20850-6314
US

IV. Provider business mailing address

9715 MEDICAL CENTER DR STE 435
ROCKVILLE MD
20850-6314
US

V. Phone/Fax

Practice location:
  • Phone: 301-424-9723
  • Fax: 301-424-9209
Mailing address:
  • Phone: 301-424-9723
  • Fax: 301-424-9209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License NumberA1271
License Number StateMD

VIII. Authorized Official

Name: DR. ROBERT HEWITT VARNEY
Title or Position: M.D.
Credential: M.D.
Phone: 301-424-9723