=====================================================
General NPI Number Information
=====================================================
NPI Number | 1437378460
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SURGICAL ASSOCIATES OF ROME MD PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/25/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1617 N JAMES ST SUITE 300
-----------------------------------------------------
City | ROME
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13440
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-337-0540
-----------------------------------------------------
Fax | 315-337-9213
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1617 N JAMES ST SUITE 300
-----------------------------------------------------
City | ROME
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13440
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-337-0540
-----------------------------------------------------
Fax | 315-337-9213
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | AMJAD RASHID
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 315-337-0540
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------