Organization
SHADY GROVE CHILDREN'S SURGERY CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY WHEELER (CEO)
(301) 494-3000
Entity
Organization
Contact information
Practice address
15001 SHADY GROVE RD STE 120, ROCKVILLE, MD 20850-6354
(301) 494-3000
Mailing address
1220 CARAWAY CT STE 1050, UPPER MARLBORO, MD 20774-5338
(301) 494-3000
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/24/2023
Last updated
04/08/2024
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