Healthcare Provider Details

I. General information

NPI: 1396076980
Provider Name (Legal Business Name): BAY SURGERY CENTERS - KENT ISLAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 02/18/2020
Certification Date: 02/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 SALLITT DR STE D
STEVENSVILLE MD
21666-2154
US

IV. Provider business mailing address

201 DEFENSE HWY STE 205
ANNAPOLIS MD
21401-7096
US

V. Phone/Fax

Practice location:
  • Phone: 410-571-2946
  • Fax:
Mailing address:
  • Phone: 443-837-9914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRITNI CULLEN
Title or Position: SR. VP
Credential:
Phone: 443-837-9913