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General NPI Number Information
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NPI Number | 1528151586
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Entity Type | Organization
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Legal Business Name | ENDOSCOPIC SURGICAL CENTRE OF MARYLAND-NORTH LLC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 15005 SHADY GROVE RD SUITE 300
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City | ROCKVILLE
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State | MD
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Zip | 20850-6340
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Country | US
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Telephone | 310-762-1280
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Fax | 301-762-5678
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Provider Business Mailing Address
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Address Line | 15005 SHADY GROVE RD SUITE 300
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City | ROCKVILLE
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State | MD
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Zip | 20850-6340
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Country | US
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Telephone | 310-762-1280
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Fax | 301-762-5678
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Authorized Official
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Title or Position | CHIEF MANAGER OF LLC
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Name | MR. CHRISTOPHER A HOLDEN
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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 | A1368
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License Number State | MD
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