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General NPI Number Information
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NPI Number | 1124443809
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Entity Type | Organization
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Legal Business Name | POOLE ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 03/04/2014
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Last Update Date | 03/04/2014
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Provider Practice Location Address
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Address Line | 826 WASHINGTON RD SUITE 218
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City | WESTMINSTER
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State | MD
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Zip | 21157-5750
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Country | US
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Telephone | 410-871-9004
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Fax | 410-871-9006
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Provider Business Mailing Address
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Address Line | 826 WASHINGTON RD SUITE 218
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City | WESTMINSTER
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State | MD
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Zip | 21157-5750
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Country | US
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Telephone | 410-871-9004
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Fax | 410-871-9006
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Authorized Official
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Title or Position | PHYSICIAN
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Name | NEEL KAMAL
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Credential | M.D.
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Telephone | 410-871-9004
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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 | D0036409
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License Number State | MD
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