Provider Demographics
NPI:1952561771
Name:MARYLAND SURGICAL CARE PC
Entity Type:Organization
Organization Name:MARYLAND SURGICAL CARE PC
Other - Org Name:CAPITOL VEIN & LASER CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCNEILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-695-8346
Mailing Address - Street 1:6410 ROCKLEDGE DR STE 650
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-7800
Mailing Address - Country:US
Mailing Address - Phone:301-581-0170
Mailing Address - Fax:301-668-7819
Practice Address - Street 1:6410 ROCKLEDGE DR STE 650
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-7800
Practice Address - Country:US
Practice Address - Phone:301-581-0170
Practice Address - Fax:301-668-7819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00458922086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty