Organization
ASC DEVELOPMENT COMPANY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J BROUILLETTE DO (REGIONAL MEDICAL DIRECTOR)
(301) 645-1523
Entity
Organization
Contact information
Practice address
3460 OLD WASHINGTON RD, STE 300, WALDORF, MD 20602-3240
(301) 645-1523
(301) 645-6812
Mailing address
PO BOX 931606, ATLANTA, GA 31193-1606
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
03/10/2011
Last updated
06/02/2025
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