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General NPI Number Information
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NPI Number | 1497751747
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Entity Type | Organization
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Legal Business Name | MID-ATLANTIC ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 09/21/2022
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Provider Practice Location Address
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Address Line | 4923 OGLETOWN STANTON RD STE 100
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City | NEWARK
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State | DE
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Zip | 19713-2081
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Country | US
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Telephone | 302-993-0310
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Fax | 302-993-0340
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Provider Business Mailing Address
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Address Line | 20 BURTON HILLS BLVD. SUITE 500, ATTN: L&C
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City | NASHVILLE
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State | TN
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Zip | 37215-6176
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Country | US
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Telephone | 615-665-1283
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Fax | 615-234-1720
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JEFFREY SNODGRASS
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Credential |
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Telephone | 615-665-1283
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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 |
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