MEDICARE: SEVEN SQUARE AMBULATORY SURGERY CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center		MD

General Provider Information

NPI Number	:	1629295522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEVEN SQUARE AMBULATORY SURGERY CENTER, INC.

Provider Business Mailing Address
First Line	:	9110 PHILADELPHIA RD
Second Line	:	SUITE 304
City	:	ROSEDALE
State	:	MD
Zip	:	21237-4301
Country	:	US
Telephone Number	:	410-686-5061
Fax Number	:	410-686-5069

Provider Business Practice Location Address
First Line	:	9110 PHILADELPHIA RD
Second Line	:	SUITE 304
City	:	ROSEDALE
State	:	MD
Zip	:	21237-4301
Country	:	US
Telephone Number	:	410-686-5061
Fax Number	:	410-686-5069

Authorized Official
Title or Position	:	DIRECTOR
Name	:	RONALD L SILVERMAN
Credential	:	D.P.M.
Telephone Number	:	410-686-5061

Provider Enumeration Date	:	04/20/2007
Last Update Date	:	08/22/2020

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