Organization
CIVISTA PARTNERS AMBULATORY SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA MCCLURE (DIRECTOR OF CLINICAL OPERATIONS)
(240) 427-1807
Entity
Organization
Contact information
Practice address
3510 OLD WASHINGTON RD, SUITE 200, WALDORF, MD 20602-3233
(240) 427-1800
Mailing address
3510 OLD WASHINGTON RD, SUITE 200, WALDORF, MD 20602-3233
(240) 427-1800
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
A1303
MD
Other
Enumeration date
11/02/2006
Last updated
07/23/2008
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