# EASTERN SHORE SURGERY CENTER LLC

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

## Provider details

- **NPI number:** 1891766283
- **Authorized official:** JOHN P KNUD HANSEN MD (AUTHORIZED OFFICIAL VICE PRESIDENT)
- **Authorized official phone:** (410) 822-5552

## Contact information

- **Practice address:** 6 CAULK LN, EASTON, MD 21601-3854
- **Practice address phone:** (410) 822-5552
- **Practice address fax:** (410) 822-8238
- **Mailing address:** 6 CAULK LN, EASTON, MD 21601-3854
- **Mailing address phone:** (410) 822-5552
- **Mailing address fax:** (410) 822-8238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/01/2006
- **Last updated:** 08/22/2020