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General NPI Number Information
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NPI Number | 1285961383
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Entity Type | Organization
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Legal Business Name | FREDERICK UROSURGICAL CENTER LLC
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Dates
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Enumeration Date | 11/10/2009
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Last Update Date | 11/10/2009
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Provider Practice Location Address
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Address Line | 110 BAUGHMANS LN SUITE 201
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City | FREDERICK
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State | MD
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Zip | 21702-4059
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Country | US
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Telephone | 301-694-8080
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Fax | 301-694-8089
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Provider Business Mailing Address
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Address Line | 110 BAUGHMANS LN SUITE 201
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City | FREDERICK
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State | MD
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Zip | 21702-4059
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Country | US
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Telephone | 301-694-8080
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Fax | 301-694-8089
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Authorized Official
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Title or Position | OWNER
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Name | DR. MOHAMMED M MOHIUDDIN
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Credential | M.D.
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Telephone | 301-694-8080
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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 |
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License Number State | MD
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