Provider Demographics
NPI:1720048242
Name:MARYLAND SURGERY CENTER FOR WOMEN LLC
Entity Type:Organization
Organization Name:MARYLAND SURGERY CENTER FOR WOMEN LLC
Other - Org Name:MARYLAND SURGERY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:SNODGRASS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-665-1283
Mailing Address - Street 1:11400 ROCKVILLE PIKE STE C25
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3063
Mailing Address - Country:US
Mailing Address - Phone:301-770-8700
Mailing Address - Fax:301-770-8730
Practice Address - Street 1:11400 ROCKVILLE PIKE
Practice Address - Street 2:SUITE C25
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-3004
Practice Address - Country:US
Practice Address - Phone:301-770-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA00038Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER