Provider Demographics
NPI:1417143041
Name:ADVANCED SURGICARE OF MARYLAND P.A
Entity Type:Organization
Organization Name:ADVANCED SURGICARE OF MARYLAND P.A
Other - Org Name:PRADIP SAHDEV MD P.A.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PRADIP
Authorized Official - Middle Name:
Authorized Official - Last Name:SAHDEV
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-645-3590
Mailing Address - Street 1:3450 OLD WASHINGTON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3248
Mailing Address - Country:US
Mailing Address - Phone:301-645-3590
Mailing Address - Fax:301-705-1941
Practice Address - Street 1:3450 OLD WASHINGTON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3248
Practice Address - Country:US
Practice Address - Phone:301-645-3590
Practice Address - Fax:301-705-1941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-18
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD579MMedicare PIN