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Organization
LUTHERVILLE SURGICENTER, LLC
Active
Organization
LUTHERVILLE SURGICENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN RUSSELL MOORE M.D. (MEDICAL DIRECTOR)
(410) 296-6232
Entity
Organization
Contact information
Practice address
1400 FRONT AVE, SUITE 100A, LUTHERVILLE, MD 21093-5300
(410) 828-1525
(410) 828-5045
Mailing address
1400 FRONT AVE, SUITE 100A, LUTHERVILLE, MD 21093-5300
(410) 828-1525
(410) 828-5045
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1302
MD
Other
Enumeration date
07/04/2006
Last updated
03/16/2008
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