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General NPI Number Information
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NPI Number | 1508931551
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Entity Type | Organization
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Legal Business Name | SURGICAL ASSOCIATES, CHARTERED
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 3510 OLD WASHINGTON RD
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City | WALDORF
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State | MD
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Zip | 20602-3233
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Country | US
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Telephone | 240-427-1720
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Fax | 240-427-1785
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Provider Business Mailing Address
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Address Line | 3510 OLD WASHINGTON RD
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City | WALDORF
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State | MD
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Zip | 20602-3233
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Country | US
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Telephone | 240-427-1720
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Fax | 240-427-1785
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Authorized Official
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Title or Position | OWNER
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Name | GARY S GROVER
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Credential | M.D.
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Telephone | 240-427-1720
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | D0024644
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License Number State | MD
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