Healthcare Provider Details

I. General information

NPI: 1740529064
Provider Name (Legal Business Name): ASC DEVELOPMENT COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2013
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8455 COLESVILLE RD 2ND FLOOR
SILVER SPRING MD
20910-3315
US

IV. Provider business mailing address

11350 MCCORMICK RD STE 501
HUNT VALLEY MD
21031-1002
US

V. Phone/Fax

Practice location:
  • Phone: 301-588-0505
  • Fax:
Mailing address:
  • Phone: 301-588-0505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RICHARD J BROUILLETTE
Title or Position: REGIONAL MEDICAL DIRECTOR
Credential: DO
Phone: 301-588-0505