Provider Demographics
NPI:1740228790
Name:CAPITAL SURGERY CENTER LLC
Entity Type:Organization
Organization Name:CAPITAL SURGERY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MAGEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-599-1000
Mailing Address - Street 1:9135 PISCATAWAY RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-2549
Mailing Address - Country:US
Mailing Address - Phone:301-599-1000
Mailing Address - Fax:301-856-7685
Practice Address - Street 1:4000 MITCHELLVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3104
Practice Address - Country:US
Practice Address - Phone:301-599-1000
Practice Address - Fax:301-856-7685
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2010-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA00040Medicare PIN