Organization
EYE CARE AND SURGICAL CENTER OF LAUREL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P GRUNDY III MD (OWNER)
(301) 725-3010
Entity
Organization
Contact information
Practice address
615 MAIN ST, LAUREL, MD 20707-4065
(301) 725-3010
(301) 725-3271
Mailing address
615 MAIN ST, LAUREL, MD 20707-4065
(301) 725-3010
(301) 725-3271
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
D52388
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
236605300
—
MD
Enumeration date
08/31/2006
Last updated
02/24/2014
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