SURGICAL ASSOCIATES CHARTERED (NPI# 1508355470) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508355470 |
Entity Type | Organization |
Organization Name | SURGICAL ASSOCIATES CHARTERED |
Practice Address |
11370 Pembrooke Sq Waldorf MD 20603-4842 |
Mailing Address |
5801 Allentown Rd Ste 502 Camp Springs MD 20746-4653 |
Practice Telephone | 2404271620 |
Practice Fax Number | 3016458663 |
Mailing Telephone | 2404271630 |
Mailing Fax Number | 2404922070 |
Enumeration Date | 2018-05-07 |
Last Update Date | 2018-05-07 |
Authorized Official Name | MRS. RITA GROVER (AUTHORIZED OFFICIAL) |
Authorized Official Telephone | 2404271630 |
Authorized Official Credential | M.D. |
Is Organization Subpart | Y |
Parent Organization Name | SURGICAL ASSOCIATES CHARTERED |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
N | 208D00000X | General Practice | Allopathic & Osteopathic Physicians | ||
N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MD | 205221100 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1003096876 | Surgical Associates Chartered | Surgery | 1667 Crofton Ctr, Suite 1, Crofton, MD 21114-1303 | 2007-11-09 |
1447439484 | Surgical Associates Chartered | Surgery | 9811 Greenbelt Rd, Suite 104, Lanham, MD 20706-2215 | 2007-10-26 |
1891974838 | Surgical Associates Chartered | Surgery | 6502 Kenilworth Ave, Suite 100, Riverdale, MD 20737-1340 | 2007-10-26 |
1659568202 | Surgical Associates Chartered | Surgery | 6502 Kenilworth Ave, Suite 200, Riverdale, MD 20737-1340 | 2007-09-27 |
1518954312 | Surgical Associates Chartered | Surgery | 5801 Allentown Rd, Suite 502, Camp Springs, MD 20746-4563 | 2005-10-05 |
Street Address |
11370 PEMBROOKE SQ |
City | WALDORF |
State | MD |
Zip Code | 20603-4842 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1912993700 | Pembrooke Square Surgery Center, LLC | Clinic/Center | 11370 Pembrooke Sq, Waldorf, MD 20603-4842 | 2005-09-27 |
1548796501 | Embarka Chaib | Nurse Practitioner | 11370 Pembrooke Sq, Waldorf, MD 20603-4842 | 2017-05-11 |
1275855637 | Meridian Anesthesia Services, LLC | Anesthesiology | 11370 Pembrooke Sq, Waldorf, MD 20603-4842 | 2010-02-25 |
1346350675 | Pembrooke Anesthesia Assoc., LLC | Anesthesiology | 11370 Pembrooke Sq, Waldorf, MD 20603-4842 | 2006-08-30 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437764214 | Kelly Weaver | Nurse Practitioner | 11315 Pembroke Square, 110, Waldorf, MD 20603 | 2020-09-09 |
1962937839 | Alexis Nicole Smith | Specialist/Technologist | 6115 Tapir Pl, Waldorf, MD 20603 | 2017-04-27 |
1235585472 | Msb Counseling Services, Inc | Counselor | 1282 Smallwood Drive W, Suite 460, Waldorf, MD 20603 | 2016-05-06 |
1619390325 | Tara Wood | Nurse Practitioner | 3070crain Highway, Waldorf, MD 20603 | 2014-01-31 |
1649603424 | Lauren Ashley White | Speech-Language Pathologist | 10810 Winchester Street Apt127, Waldorf, MD 20603 | 2013-08-15 |
1477810067 | Johnathan Vital | Clinical Neuropsychologist | 2413 Altenburg Ct, Waldorf, MD 20603 | 2012-04-19 |
1831480615 | Tara Marie Adams | Physical Therapist | 11340 Pembrooke Sq Ste 211, Waldorf, MD 20603 | 2011-04-27 |
1891007662 | Tanuja Katta | Pharmacist | 3385 Crain High Way, Rite Aid 11197, Waldorf, MD 20603 | 2010-07-09 |
1962725697 | Rhonda Bumpers-bland | Occupational Therapist | 2945 Fern Hill Place, Waldorf, MD 20603 | 2010-03-09 |
1265672901 | Shannon L Hamm | Counselor | 6126 Gray Wolf Court, Waldorf, MD 20603 | 2009-02-20 |
Find all providers in zip 20603 |
Taxonomy Code | 2086S0129X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Vascular Surgery |
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1730480872 | James F Mcguckin Md of Md Pa | Surgery | 3450 Old Washington Rd Ste 202, Waldorf, MD 20602-3250 | 2010-11-05 |
1508931551 | Surgical Associates, Chartered | Surgery | 3510 Old Washington Rd, Waldorf, MD 20602-3233 | 2006-11-22 |
1861447401 | Surgical Associates, Chartered | Surgery | 11340 Pembrooke Sq, Suite 213, Waldorf, MD 20603-4808 | 2006-05-23 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1326678731 | Nova Vascular Specialists, LLC | Surgery | 1952 Pulaski Hwy Ste B-2, Edgewood, MD 21040-1658 | 2020-01-24 |
1033683339 | Vein and Vascular Institute of Central Maryland | Surgery | 1300 York Rd Ste 200, Lutherville, MD 21093-6090 | 2019-01-20 |
1932651312 | Elham Oumer | Surgery | 8730 Cherry Ln Ste 10, Laurel, MD 20707-6212 | 2016-11-01 |
1255742961 | Marta Vismer | Surgery | 19942 Gateshead Cir, Germantown, MD 20876-6311 | 2014-05-15 |
1023448305 | Samer Saiedy Md Gb LLC | Surgery | 1811 Crain Hwy S, Glen Burnie, MD 21061-5561 | 2013-11-22 |
1285077289 | Lucy Kupersmith | Surgery | 2002 Medical Pkwy Ste 502, Annapolis, MD 21401 | 2013-04-10 |
1316227150 | Joshua Dearing | Surgery | 7503 Surratts Rd Ste 208, Clinton, MD 20735-3358 | 2011-08-25 |
1861782492 | Norman Anthony Odyniec | Surgery | 9208 Levelle Dr, Chevy Chase, MD 20815-5604 | 2011-04-16 |
1194952796 | James M Salander, Md Pa | Surgery | 11119 Rockville Pile, #204, Rockville, MD 20852 | 2009-06-22 |
1275783292 | William Herman Rogers | Surgery | 38 Arundel Rd, Annapolis, MD 21401-1206 | 2008-09-26 |
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.