# SHADY GROVE SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194222620
- **Authorized official:** DR. SHABNAM DADGAR (MD)
- **Authorized official phone:** (240) 912-4546

## Contact information

- **Practice address:** 10810 DARNESTOWN RD STE 202, GAITHERSBURG, MD 20878-2601
- **Practice address phone:** (240) 912-4546
- **Practice address fax:** (240) 912-4471
- **Mailing address:** 10810 DARNESTOWN RD STE 202, GAITHERSBURG, MD 20878-2601
- **Mailing address phone:** (240) 912-4546
- **Mailing address fax:** (240) 912-4471

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/11/2018
- **Last updated:** 12/05/2025