Healthcare Provider Details
I. General information
NPI: 1598136186
Provider Name (Legal Business Name): VEDA SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/08/2015
Last Update Date: 10/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
530 E JOPPA ROAD
TOWSON MD
21286-5403
US
IV. Provider business mailing address
713 HAWKSHEAD RD
TIMONIUM MD
21093-7019
US
V. Phone/Fax
- Phone: 410-830-1794
- Fax: 410-296-6689
- Phone: 410-830-1794
- Fax: 410-296-6689
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 | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name:
RAVI
K
ALOOR
Title or Position: SURGEON
Credential: MD FRCS
Phone: 410-830-1794