MEDICARE: WESTERN MARYLAND SURGICENTER LLP

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	A1198	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
7	490002966	OTHER	MD	MEDICARE GBA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	21C-0001198	OTHER	MD	CMS (HCFA)
2	583732	OTHER	MD	RENDERING BC/BS CARE 1ST
3	PT 9-7-1-02	OTHER	MD	BLUE CHOICE (GHMSI)
4	021CWE	OTHER	MD	CAREFIRST GROUP
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	241851	OTHER	MD	MAMSI/MDIPA

General Provider Information

NPI Number	:	1740283837
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WESTERN MARYLAND SURGICENTER LLP

Provider Business Mailing Address
First Line	:	925 BISHOP WALSH RD
Second Line	:	STE 2
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-1845
Country	:	US
Telephone Number	:	301-722-0708
Fax Number	:	301-777-3135

Provider Business Practice Location Address
First Line	:	925 BISHOP WALSH RD
Second Line	:	STE 2
City	:	CUMBERLAND
State	:	MD
Zip	:	21502-1845
Country	:	US
Telephone Number	:	301-722-0708
Fax Number	:	301-777-3135

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. HOWARD ROBERT STRAUSS
Credential	:	DDS
Telephone Number	:	301-777-8227

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/21/2014

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