Organization
MCLEAN AMBULATORY SURGERY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARASINH PHOUMMITHONE MAYARD AUTHORIZED OFFICIAL (A/R & OPERATIONS MANAGER)
(703) 395-6410
Entity
Organization
Contact information
Practice address
7601 LEWINSVILLE RD, SUITE 440, MC LEAN, VA 22102-2814
(703) 663-1440
(703) 752-1105
Mailing address
7601 LEWINSVILLE RD, SUITE 440, MCLEAN, VA 22102-2834
(703) 663-1440
(703) 752-1105
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
09/30/2015
Last updated
03/13/2024
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