Provider Demographics
NPI:1730197633
Name:SURGERY CENTER OF MARYLAND LLC
Entity type:Organization
Organization Name:SURGERY CENTER OF MARYLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:L
Authorized Official - Last Name:CUNEO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-598-2894
Mailing Address - Street 1:3801 INTERNATIONAL DRIVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906
Mailing Address - Country:US
Mailing Address - Phone:301-598-5100
Mailing Address - Fax:301-598-2894
Practice Address - Street 1:3801 INTERNATIONAL DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906
Practice Address - Country:US
Practice Address - Phone:301-598-5100
Practice Address - Fax:301-598-2894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
312645Medicare ID - Type Unspecified