Provider Demographics
NPI:1790062636
Name:BAY SURGERY CENTERS - WALDORF, LLC
Entity Type:Organization
Organization Name:BAY SURGERY CENTERS - WALDORF, LLC
Other - Org Name:CLEARWAY SURGERY CENTER OF WALDORF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAMEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:410-571-2946
Mailing Address - Street 1:201 DEFENSE HWY STE 205
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7096
Mailing Address - Country:US
Mailing Address - Phone:443-837-9914
Mailing Address - Fax:410-571-2947
Practice Address - Street 1:2960 TECHNOLOGY PL STE 103A
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20601-4968
Practice Address - Country:US
Practice Address - Phone:410-571-2946
Practice Address - Fax:410-571-2947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-07
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical