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General NPI Number Information
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NPI Number | 1336288224
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Entity Type | Organization
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Legal Business Name | EYE SURGERY CENTER OF WHITE MARSH, LLC
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9512 HARFORD RD SUITE 5
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City | BALTIMORE
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State | MD
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Zip | 21234-3120
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Country | US
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Telephone | 410-663-4466
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Fax | 410-663-4556
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Provider Business Mailing Address
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Address Line | 9512 HARFORD RD SUITE 5
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City | BALTIMORE
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State | MD
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Zip | 21234-3120
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Country | US
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Telephone | 410-663-4466
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Fax | 410-663-4556
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ROBERT KASPER
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Credential | MD
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Telephone | 410-663-4466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number | A1374
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License Number State | MD
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