Provider Demographics
NPI:1861449571
Name:KIRURGS, LLC
Entity Type:Organization
Organization Name:KIRURGS, LLC
Other - Org Name:SURGEONS' SURGICAL CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:S
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:301-777-2543
Mailing Address - Street 1:PO BOX 714402
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45271-4402
Mailing Address - Country:US
Mailing Address - Phone:301-777-2543
Mailing Address - Fax:301-777-2583
Practice Address - Street 1:940 SETON DR
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1818
Practice Address - Country:US
Practice Address - Phone:301-777-2543
Practice Address - Fax:301-777-2583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1278261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD056902000Medicaid
MD056902000Medicaid