Organization
LANDOVER AMBULATORY SURGERY, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ADAEZE I. OBIOHA (ADMINISTRATIVE DIRECTOR)
(301) 773-3338
Entity
Organization
Contact information
Practice address
1300 MERCANTILE LN, SUITE 190, LARGO, MD 20774-5327
(301) 773-3338
(301) 773-3305
Mailing address
1300 MERCANTILE LN, SUITE 190, LARGO, MD 20774-5327
(301) 773-3338
(301) 773-3305
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1294
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A1294
LICENSE
MD
Enumeration date
10/16/2006
Last updated
08/22/2020
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