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Organization

SHADY GROVE ANESTHESIA ASSOCIATE LLC

Active
Parent organization
SHADY GROVE FERTILITY RSC
Organization subpart
Yes

Provider details

NPI number
Legal business name
SHADY GROVE FERTILITY RSC
Authorized official
SHELLY SHAPIRO (CHIEF FINANCIAL OFFICER)
(301) 545-1407
Entity
Organization

Contact information

Practice address
9600 BLACKWELL ROAD, SUITE 500, ROCKVILLE, MD 20850-6478
(301) 340-1188
(301) 340-1612
Mailing address
9600 BLACKWELL RD STE 500, ROCKVILLE, MD 20850-3783
(301) 340-1188
(301) 340-1612

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R115576
MD

Other

Enumeration date
04/23/2013
Last updated
02/16/2018
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