Organization
ASC DEVELOPMENT COMPANY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J BROUILLETTE DO (REGIONAL MEDICAL DIRECTOR)
(410) 787-8315
Entity
Organization
Contact information
Practice address
8824 CUNNINGHAM DR, SUITE D, BERWYN HEIGHTS, MD 20740-2338
(240) 965-0800
(240) 290-0037
Mailing address
PO BOX 931606, ATLANTA, GA 31193-1606
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/18/2011
Last updated
06/02/2025
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