Healthcare Provider Details

I. General information

NPI: 1518634732
Provider Name (Legal Business Name): MEDSTAR HEALTH ENDOSCOPY CENTER - SILVER SPRING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12002 VEIRS MILL RD
SILVER SPRING MD
20906-4513
US

IV. Provider business mailing address

12002 VEIRS MILL RD
SILVER SPRING MD
20906-4513
US

V. Phone/Fax

Practice location:
  • Phone: 301-370-0810
  • Fax: 301-774-0505
Mailing address:
  • Phone: 301-370-0810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0800X
TaxonomyEndoscopy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT GILBERT
Title or Position: MANAGING MEMBER
Credential:
Phone: 410-772-6696