MIVC ASC, LLC (NPI# 1174074538) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174074538 |
| Entity Type | Organization |
| Organization Name | MIVC ASC, LLC |
| Practice Address |
9201 Cherry Lane Laurel MD 20707 |
| Mailing Address |
8730 Cherry Ln Suite 10 Laurel MD 20707-6212 |
| Practice Telephone | 3014971590 |
| Mailing Telephone | 3014971590 |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2016-11-02 |
| Authorized Official Name | DR. JEFFERY JARWRI DORMU (CEO/VASCULAR SURGEON) |
| Authorized Official Telephone | 3014971590 |
| Authorized Official Credential | DO |
| Is Organization Subpart | Y |
| Parent Organization Name | MINIMALLY INVASIVE VASCULAR CENTER OF MARYLAND |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
9201 CHERRY LANE |
| City | LAUREL |
| State | MD |
| Zip Code | 20707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699735506 | Salvador Rodrigo Guerrero | Family Medicine | 9201 Cherry Lane, Laurel, MD 20708 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376157156 | Mini'imah Wilson | Social Worker | 15041 Cherrywood Dr, Laurel, MD 20707 | 2020-08-31 |
| 1548893985 | Ernest Freeman | Clinic/Center | 367 Main St., Laurel, Laurel, MD 20707 | 2020-02-13 |
| 1538701859 | Family Health and Wellness Clinic LLC | Clinic/Center | 324 Main St. #523, Laurel, MD 20707 | 2019-10-09 |
| 1467018226 | Leena Daniel | Nurse Practitioner | 13 C Street, Suite D, Laurel, MD 20707 | 2019-05-16 |
| 1538723143 | Florence Okojie | Nurse Practitioner | 13 C St Ste G, Laurel, MD 20707 | 2019-04-29 |
| 1487148631 | Munsha Sidhu Chadha | Dentist | 595 Main St Ste 237, Laurel, MD 20707 | 2018-06-20 |
| 1568953370 | Carleen Graham Schwimmer | Clinical Neuropsychologist | Veterans Affairs War Related Illness & Injury (wriisc), 50 Irving Street Nw, Washington, MD 20707 | 2018-05-29 |
| 1043709637 | Bk Behavioral Health Center | Behavior Technician | 14300 Cherry Lane Ct Ste 202-203, Laurel, MD 20707 | 2018-05-09 |
| 1053800839 | Bk Behaviorial Health Center | Substance Abuse Rehabilitation Facility | 14300 Cherry Lane Court, Suite 202-203, Laurel, MD 20707 | 2018-05-07 |
| 1316435795 | Laurel Pharmacy II LLC | Pharmacy | 14402 Baltimore Ave, Laurel, MD 20707 | 2018-05-01 |
| Find all providers in zip 20707 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558876367 | Park Center Surgical Center LLC | Clinic/Center | 14201 Park Center Dr Ste 408, Laurel, MD 20707-5251 | 2017-12-04 |
| 1992904734 | Laurel Foot and Ankle Surgery Center | Clinic/Center | 14440 Cherry Lane Ct Ste 104, Laurel, MD 20707-4946 | 2007-07-12 |
| 1689605826 | Laurel Surgery & Endoscopy Center, LLC | Clinic/Center | 1710 W 12th St, Laurel, MS 39440-2559 | 2006-07-05 |
| 1609871680 | Laurel Md Endoscopy Asc LLC | Clinic/Center | 7350 Van Dusen Rd, Ste 230, Laurel, MD 20707-5263 | 2005-06-16 |
| 1770734915 | Laurel Lakes Foot and Ankle Center, LLC | Clinic/Center | 13950 Baltimore Ave, Laurel, MD 20707-5000 | 2008-10-07 |
| 1457520983 | Laurel Lakes Foot and Ankle Asc | Clinic/Center | 13950 Baltimore Ave, Laurel, MD 20707-5000 | 2008-02-28 |
| 1841483443 | Main Street Ambulatory Surgical Ctr | Clinic/Center | 632 Main St, Laurel, MD 20707-4070 | 2007-08-27 |
| 1518020999 | Pain Treatment Center of Laurel LLC | Clinic/Center | 404 S 13th Ave, Laurel, MS 39440-4345 | 2006-12-18 |
| 1811958218 | Enk Surgicenter,llc | Clinic/Center | 7350 Van Dusen Rd, Suite 470, Laurel, MD 20707-5263 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807961 | Vascular Surgery Center of Abingdon | Clinic/Center | 3435 Box Hill Corporate Center Dr Ste H, Abingdon, MD 21009-1204 | 2020-10-02 |
| 1518570084 | Eastside Anesthesia LLC | Clinic/Center | 19 Fontana Ln Ste 104, Rosedale, MD 21237-3027 | 2020-08-25 |
| 1215548524 | Summit Ambulatory Surgical Center, LLC | Clinic/Center | 800 Bestgate Rd Ste 200, Annapolis, MD 21401-3016 | 2020-08-11 |
| 1861001372 | Bay Surgery Centers LLC | Clinic/Center | 810 Bestgate Rd Ste 120, Annapolis, MD 21401-3033 | 2020-07-30 |
| 1417566217 | Clearway Surgery Center of Easton, LLC | Clinic/Center | 598 Cynwood Dr Ste 103, Easton, MD 21601-3875 | 2020-07-28 |
| 1932718822 | Charles Regional Surgical Center LLC | Clinic/Center | 5 North Laplata Court, 2nd Floor, Laplata, MD 20646 | 2020-07-27 |
| 1528680865 | Meridian Surgery Center LLC | Clinic/Center | 19638 Leitersburg Pike Ste 205, Hagerstown, MD 21742-1515 | 2020-05-09 |
| 1346862869 | Nspc Surgery Center of Maryland, LLC | Clinic/Center | 6710 Oxon Hill Rd Ste 550b, Oxon Hill, MD 20745-1117 | 2020-05-07 |
| 1225665292 | Annapolis Endoscopy Center LLC | Clinic/Center | 1419 Forest Dr Ste 105, Annapolis, MD 21403-1474 | 2020-03-26 |
| 1992345748 | Podiatry Associates Ambulatory Surgical Centers LLC | Clinic/Center | 9105 Franklin Square Dr Ste 206, Baltimore, MD 21237-3954 | 2020-01-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.