Organization
MT AIRY SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN K KELBY (SR VICE PRESIDENT-FINANCE)
(410) 848-3000
Entity
Organization
Contact information
Practice address
1001 TWIN ARCH RD, SUITE 3C, MOUNT AIRY, MD 21771-4138
(410) 549-2100
(410) 549-2807
Mailing address
1001 TWIN ARCH RD, SUITE 3C, MOUNT AIRY, MD 21771-4138
(410) 549-2100
(410) 549-2807
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1089
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
430400400
—
MD
Enumeration date
07/08/2005
Last updated
01/27/2009
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