Organization
FREDERICK SURGICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS A NEWMAN (EVP AND COO)
(405) 608-1709
Entity
Organization
Contact information
Practice address
45 THOMAS JOHNSON DRIVE, SUITE 207, FREDERICK, MD 21702
(301) 694-3400
(301) 694-3620
Mailing address
14000 N. PORTLAND AVENUE, SUITE 200, OKLAHOMA CITY, OK 73134-4004
(405) 608-1766
(405) 608-1866
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1039
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
269918
MAMSI
MD
05
—
414472400
—
MD
01
—
ZZ70
MEDICARE PROVIDER NUMBER
MD
Enumeration date
07/15/2005
Last updated
10/07/2014
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