Organization
SMART PAIN SURGERY CENTER AT OWINGS MILLS, LLC
Active
Other names
SMART Pain Surgery Center, LLC, Clearway Surgery Center of Owings Mills
Organization subpart
No
Provider details
NPI number
Authorized official
IRA KORNBLUTH MD (PRESIDENT)
(855) 527-7246
Entity
Organization
Contact information
Practice address
9 PARK CENTER CT., SUITE 100, OWINGS MILLS, MD 21117
(410) 205-7667
(410) 205-7274
Mailing address
201 DEFENSE HWY STE 205, ANNAPOLIS, MD 21401-7096
(855) 527-7246
(866) 229-5063
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1555
MD
261QA1903X
Ambulatory Surgical Clinic/Center
D0061293
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
347179
MEDICARE
MD
05
—
422785900
—
MD
Enumeration date
08/21/2013
Last updated
06/19/2024
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