Provider Demographics
NPI:1548423981
Name:MARYLAND SURGICENTER, LLC
Entity Type:Organization
Organization Name:MARYLAND SURGICENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALYSON
Authorized Official - Middle Name:D
Authorized Official - Last Name:WELLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-628-8200
Mailing Address - Street 1:10151 YORK RD
Mailing Address - Street 2:SUITE 112-114
Mailing Address - City:HUNT VALLEY
Mailing Address - State:MD
Mailing Address - Zip Code:21030-3314
Mailing Address - Country:US
Mailing Address - Phone:410-628-8200
Mailing Address - Fax:
Practice Address - Street 1:10151 YORK RD
Practice Address - Street 2:SUITE 112-114
Practice Address - City:HUNT VALLEY
Practice Address - State:MD
Practice Address - Zip Code:21030-3314
Practice Address - Country:US
Practice Address - Phone:410-628-8200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherEIN