Organization
SUMMIT AMBULATORY SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANFORD J. SIEGEL MD (PRESIDENT)
(443) 738-2872
Entity
Organization
Contact information
Practice address
7625 MAPLE LAWN BLVD, SUITE 205, FULTON, MD 20759-2565
(443) 738-2872
Mailing address
25 CROSSROADS DR, SUITE 306, OWINGS MILLS, MD 21117-5421
(443) 738-2872
(443) 738-2713
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800906616
—
MD
Enumeration date
01/16/2009
Last updated
08/26/2011
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