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Organization

LAKEFOREST AMBULATORY SURGERY CENTER

Active
Other names
District Heights Ambulatory Surgery Center
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL LAWRENCE MICHETTI DPM (MEDICAL DIRECTOR AND OWNER)
(301) 948-3668
Entity
Organization

Contact information

Practice address
6400 MARLBORO PIKE, DISTRICT HEIGHTS, MD 20747-2841
(301) 736-6900
(301) 736-7180
Mailing address
702 RUSSELL AVE, SUITE 103, GAITHERSBURG, MD 20877-2606
(301) 948-3668
(301) 926-7787

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1136
MD

Other

Enumeration date
07/11/2008
Last updated
07/11/2008
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