Healthcare Provider Details
I. General information
NPI: 1730197633
Provider Name (Legal Business Name): SURGERY CENTER OF MARYLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3801 INTERNATIONAL DRIVE SUITE 300
SILVER SPRING MD
20906
US
IV. Provider business mailing address
3801 INTERNATIONAL DRIVE SUITE 300
SILVER SPRING MD
20906
US
V. Phone/Fax
- Phone: 301-598-5100
- Fax: 301-598-2894
- Phone: 301-598-5100
- Fax: 301-598-2894
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA1903X |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SARAH
L
CUNEO
Title or Position: ADMINISTRATOR
Credential:
Phone: 301-598-2894