Provider Demographics
NPI:1497805402
Name:AMERICAN SURGICARE PC
Entity Type:Organization
Organization Name:AMERICAN SURGICARE PC
Other - Org Name:SURGICORP DR OKAY HAROLD ODOCHA MD FACS
Other - Org Type:Other Name
Authorized Official - Title/Position:SURGEON PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:OKAY
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:ODOCHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-526-7091
Mailing Address - Street 1:1140 VARNUM ST NE
Mailing Address - Street 2:SUITE #102
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017
Mailing Address - Country:US
Mailing Address - Phone:202-526-7091
Mailing Address - Fax:202-526-7093
Practice Address - Street 1:1140 VARNUM ST NE
Practice Address - Street 2:SUITE #102
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017
Practice Address - Country:US
Practice Address - Phone:202-526-7091
Practice Address - Fax:202-526-7093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2009-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
75410001OtherBLUE CROSS BLUE SHIELD
DC029945200Medicaid
F68649Medicare UPIN
416329Medicare ID - Type Unspecified