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General NPI Number Information
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NPI Number | 1801847850
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Entity Type | Organization
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Legal Business Name | MARYLAND PLASTIC SURGERY, LLC
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 1520 JABEZ RUN STE 200
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2005
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Country | US
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Telephone | 410-553-9444
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 JABEZ RUN
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City | MILLERSVILLE
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State | MD
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Zip | 21108-2005
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Country | US
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Telephone | 410-553-9444
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ADAM N. SUMMERS
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Credential | MD
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Telephone | 410-553-9444
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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 | DOO55340
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License Number State | MD
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