Provider Demographics
NPI:1003418492
Name:BOWIE SURGERY CENTER
Entity Type:Organization
Organization Name:BOWIE SURGERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:KWASI
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-867-1551
Mailing Address - Street 1:12200 ANNAPOLIS RD STE 123
Mailing Address - Street 2:
Mailing Address - City:GLENN DALE
Mailing Address - State:MD
Mailing Address - Zip Code:20769-9182
Mailing Address - Country:US
Mailing Address - Phone:301-552-4300
Mailing Address - Fax:
Practice Address - Street 1:12200 ANNAPOLIS RD STE 123
Practice Address - Street 2:
Practice Address - City:GLENN DALE
Practice Address - State:MD
Practice Address - Zip Code:20769-9182
Practice Address - Country:US
Practice Address - Phone:301-552-4300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical