Provider Demographics
NPI:1548222912
Name:VASCULAR SURGERY ASSOCIATES, L.L.C.
Entity Type:Organization
Organization Name:VASCULAR SURGERY ASSOCIATES, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REVENUE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ALLERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-879-2006
Mailing Address - Street 1:520 UPPER CHESAPEAKE DR
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4339
Mailing Address - Country:US
Mailing Address - Phone:410-879-2006
Mailing Address - Fax:410-879-0248
Practice Address - Street 1:520 UPPER CHESAPEAKE DR
Practice Address - Street 2:SUITE 306
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-4339
Practice Address - Country:US
Practice Address - Phone:410-879-2006
Practice Address - Fax:410-879-0248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD2086S0129X
2086S0129X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD348471800Medicaid