Healthcare Provider Details

I. General information

NPI: 1003853136
Provider Name (Legal Business Name): SILVER SPRING OPHTHALMOLOGY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2006
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8630 FENTON ST SUITE 800
SILVER SPRING MD
20910-3806
US

IV. Provider business mailing address

8630 FENTON STREET SUITE 800
SILVER SPRING MD
20910
US

V. Phone/Fax

Practice location:
  • Phone: 301-585-8880
  • Fax: 301-585-6521
Mailing address:
  • Phone: 301-585-8880
  • Fax: 301-585-6521

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License NumberA1177
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. CHARLES BAHN
Title or Position: MANAGER
Credential: M.D.
Phone: 301-657-3022