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Organization
ENDOSCOPIC SURGICAL CENTRE OF MARYLAND-NORTH LLC
Active
Organization
ENDOSCOPIC SURGICAL CENTRE OF MARYLAND-NORTH LLC
Active
Other names
Endoscopic Surgical Centre of Maryland North
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRISTOPHER A HOLDEN (CHIEF MANAGER OF LLC)
(615) 665-1283
Entity
Organization
Contact information
Practice address
15005 SHADY GROVE RD, SUITE 300, ROCKVILLE, MD 20850-6340
(310) 762-1280
(301) 762-5678
Mailing address
15005 SHADY GROVE RD, SUITE 300, ROCKVILLE, MD 20850-6340
(310) 762-1280
(301) 762-5678
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1368
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236707
MAMSI PROVIDER NUMBER
—
01
—
237001
KAISER INSURANCE
MD
01
—
522576
NCPPO
—
01
—
61779101
BC/BS OF MARYLAND
MD
01
—
6800326
UNITEDHEALTHCARE PROVIDER
MD
01
—
PY6
BC/BS OF DC
—
Enumeration date
10/02/2006
Last updated
04/20/2008
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