Healthcare Provider Details

I. General information

NPI: 1942233259
Provider Name (Legal Business Name): SILVER SPRING SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 04/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 SPRING ST SUITE 130
SILVER SPRING MD
20910-4003
US

IV. Provider business mailing address

1111 SPRING ST SUITE 130
SILVER SPRING MD
20910-4003
US

V. Phone/Fax

Practice location:
  • Phone: 301-588-1425
  • Fax: 301-588-1490
Mailing address:
  • Phone: 301-588-1425
  • Fax: 301-588-1490

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: MRS. ADAEZE I. OBIOHA
Title or Position: ADMINISTRATIVE DIRECTOR
Credential:
Phone: 301-588-1425