Organization
PODIATRY ASSOCIATES AMBULATORY SURGICAL CENTERS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA D BAKER (EXECUTIVE DIRECTOR)
(410) 838-0179
Entity
Organization
Contact information
Practice address
1 N MAIN ST STE 1, BEL AIR, MD 21014-3592
(410) 879-1212
Mailing address
1 N MAIN ST, BEL AIR, MD 21014-3592
(410) 879-1763
(410) 803-1859
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1013
MD
261QA1903X
Ambulatory Surgical Clinic/Center
A1014
MD
261QA1903X
Ambulatory Surgical Clinic/Center
A1015
MD
261QA1903X
Ambulatory Surgical Clinic/Center
A1017
MD
261QA1903X
Ambulatory Surgical Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
418393200
—
MD
01
—
NN4
BCBS-MD
MD
Enumeration date
12/05/2006
Last updated
08/19/2021
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