Organization
MARYLAND AMBULATORY SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRISTAN SHOCKLEY (OWNER)
(301) 850-4401
Entity
Organization
Contact information
Practice address
7501 FORBES BLVD STE 103, LANHAM, MD 20706-6201
(202) 498-1125
(240) 770-0436
Mailing address
7501 FORBES BLVD STE 103, LANHAM, MD 20706-6201
(301) 850-4401
(301) 850-4402
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/17/2020
Last updated
06/30/2021
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