=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770551517
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUTHERN MARYLAND ENDOSCOPY CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/09/2006
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 125 POTOMAC PSGE STE 200
-----------------------------------------------------
City | NATIONAL HARBOR
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20745-1580
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-877-4140
-----------------------------------------------------
Fax | 202-296-0301
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5550 FRIENDSHIP BLVD STE T90
-----------------------------------------------------
City | CHEVY CHASE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20815-7313
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 301-654-4148
-----------------------------------------------------
Fax | 202-296-0301
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | MICHAEL L WEINSTEIN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 301-877-4140
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA1903X
-----------------------------------------------------
Taxonomy Name | Ambulatory Surgical Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------