Provider Demographics
NPI:1629016076
Name:UNIVERSITY CENTER FOR AMBULATORY SURGERY, LLC
Entity Type:Organization
Organization Name:UNIVERSITY CENTER FOR AMBULATORY SURGERY, LLC
Other - Org Name:UCAS, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SUMMERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-927-4200
Mailing Address - Street 1:6502 KENILWORTH AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:RIVERDALE
Mailing Address - State:MD
Mailing Address - Zip Code:20737-1340
Mailing Address - Country:US
Mailing Address - Phone:301-927-4200
Mailing Address - Fax:301-927-0056
Practice Address - Street 1:6502 KENILWORTH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1340
Practice Address - Country:US
Practice Address - Phone:301-927-4200
Practice Address - Fax:301-927-0056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA00032Medicare ID - Type Unspecified