# CIVISTA PARTNERS AMBULATORY SURGERY CENTER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1902984321
- **Authorized official:** MRS. DEBRA MCCLURE (DIRECTOR OF CLINICAL OPERATIONS)
- **Authorized official phone:** (240) 427-1807

## Contact information

- **Practice address:** 3510 OLD WASHINGTON RD, SUITE 200, WALDORF, MD 20602-3233
- **Practice address phone:** (240) 427-1800
- **Mailing address:** 3510 OLD WASHINGTON RD, SUITE 200, WALDORF, MD 20602-3233
- **Mailing address phone:** (240) 427-1800

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | A1303 | MD | Yes |

## Other

- **Enumeration date:** 11/02/2006
- **Last updated:** 07/23/2008