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General NPI Number Information
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NPI Number | 1841362720
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Entity Type | Organization
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Legal Business Name | GENERAL SURGERY AMBULATORY SURGICAL CENTER, A.S.C., L.L.C.
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 12/23/2010
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Provider Practice Location Address
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Address Line | 3333 N CALVERT ST SUITE 655
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City | BALTIMORE
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State | MD
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Zip | 21218-2867
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Country | US
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Telephone | 410-321-8720
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Fax | 410-321-8723
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Provider Business Mailing Address
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Address Line | PO BOX 10714
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City | TOWSON
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State | MD
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Zip | 21285-0714
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Country | US
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Telephone | 410-321-8720
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Fax | 410-321-8723
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAEN J. FARHA
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Credential | M.D.
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Telephone | 410-321-8720
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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 | A1289
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License Number State | MD
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