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Organization

PHOENIX SURGICAL CARE LLC

Active
Other names
Phoenix Surgical Care
Organization subpart
No

Provider details

NPI number
Authorized official
JASMINE MALCOLM MD (OWNER)
(301) 662-2000
Entity
Organization

Contact information

Practice address
174 THOMAS JOHNSON DR STE 100, FREDERICK, MD 21702-4569
(301) 662-2000
(301) 662-2500
Mailing address
174 THOMAS JOHNSON DR STE 100, FREDERICK, MD 21702-4569
(301) 662-2000
(301) 662-2500

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D0073819
STATE OF MARYLAND (DEPARTMENT OF HEALTH)
MD
Enumeration date
03/19/2020
Last updated
07/12/2022
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