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General NPI Number Information
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NPI Number | 1114168192
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Entity Type | Organization
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Legal Business Name | LUXXERY CORPORATION OF MARYLAND
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Dates
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Enumeration Date | 03/20/2009
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 3010 CRAIN HWY SUITE 400
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City | WALDORF
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State | MD
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Zip | 20601-2801
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Country | US
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Telephone | 301-843-9769
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Fax | 301-843-8941
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Provider Business Mailing Address
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Address Line | 3010 CRAIN HIGHWAY SUITE 400
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City | WALDORF
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State | MD
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Zip | 20601
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Country | US
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Telephone | 301-843-9769
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Fax | 301-843-8941
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AYMAN HAKKI
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Credential | M.D.
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Telephone | 301-843-9769
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | D0035306
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License Number State | MD
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