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General NPI Number Information
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NPI Number | 1972141455
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Entity Type | Organization
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Legal Business Name | FALLSGROVE ENDOSCOPY CENTER, LLC
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Dates
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Enumeration Date | 12/16/2019
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Last Update Date | 11/04/2025
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Provider Practice Location Address
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Address Line | 15001 SHADY GROVE RD STE 400 4TH FLOOR
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City | ROCKVILLE
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State | MD
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Zip | 20850-6352
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Country | US
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Telephone | 215-589-9024
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Fax | 833-705-6301
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Provider Business Mailing Address
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Address Line | 15001 SHADY GROVE RD STE 4004TH
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City | ROCKVILLE
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State | MD
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Zip | 20850-6352
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Country | US
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Telephone | 301-800-7001
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Fax | 301-800-7011
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MAYBELL CAMPBELL
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Credential |
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Telephone | 301-800-7001
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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 |
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License Number State |
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