Provider Demographics
NPI:1740283837
Name:WESTERN MARYLAND SURGICENTER LLP
Entity type:Organization
Organization Name:WESTERN MARYLAND SURGICENTER LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HOWARD
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:STRAUSS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:301-777-8227
Mailing Address - Street 1:925 BISHOP WALSH RD
Mailing Address - Street 2:STE 2
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-1845
Mailing Address - Country:US
Mailing Address - Phone:301-722-0708
Mailing Address - Fax:301-777-3135
Practice Address - Street 1:925 BISHOP WALSH RD
Practice Address - Street 2:STE 2
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1845
Practice Address - Country:US
Practice Address - Phone:301-722-0708
Practice Address - Fax:301-777-3135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-23
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1198261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD21C-0001198OtherCMS (HCFA)
MD583732OtherRENDERING BC/BS CARE 1ST
MDPT 9-7-1-02OtherBLUE CHOICE (GHMSI)
MD021CWEOtherCAREFIRST GROUP
MD331-331-000Medicaid
MD241851OtherMAMSI/MDIPA
MD490002966OtherMEDICARE GBA
MD21C-0001198OtherCMS (HCFA)
MD490002966OtherMEDICARE GBA