NEWBRIDGE SURGERY CENTER AT WALDORF (NPI# 1710112669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710112669 |
| Entity Type | Organization |
| Organization Name | NEWBRIDGE SURGERY CENTER AT WALDORF |
| Practice Address |
3581 Old Washington Road Suite G Waldorf MD 20602 |
| Mailing Address |
196 Thomas Johnson Dr Suite 215 Frederick MD 21702-4397 |
| Practice Telephone | 3016384400 |
| Practice Fax Number | 3016382200 |
| Mailing Telephone | 3016689988 |
| Mailing Fax Number | 3016689977 |
| Enumeration Date | 2009-05-21 |
| Last Update Date | 2012-08-29 |
| Authorized Official Name | MRUTHYUNJAYA GONCHIGAR (OWNER/PHYSICIAN) |
| Authorized Official Telephone | 3016689988 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| Street Address |
3581 OLD WASHINGTON ROAD SUITE G |
| City | WALDORF |
| State | MD |
| Zip Code | 20602 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053964957 | Haeyoung Choi | Pharmacist | 25 Smallwood Village Center, Waldorf, MD 20602 | 2019-07-19 |
| 1679137194 | Brighter Days Family Services Inc | Counselor | 11680 Doolittle Dr #111, Waldorf, MD 20602 | 2019-04-30 |
| 1396227039 | Lantern Family Services Inc | Community/Behavioral Health | 11680 Doolittle Dr Ste 111, Waldorf, MD 20602 | 2018-08-29 |
| 1093294910 | Metropolitan Vascular Institute LLC | Internal Medicine | 12070 Old Line Ctr Ste 100, Waldorf, MD 20602 | 2018-08-10 |
| 1174009922 | Dr. Arthur B. Sorkin, D.d.s., LLC | Dentist | 3460 Old Washington Rd., Suite 301-b, Waldorf, MD 20602 | 2018-07-16 |
| 1467945030 | Donna Marie Conley-shaw | Behavior Technician | 16 Pagnell Cir, Waldorf, MD 20602 | 2018-06-08 |
| 1811404296 | Loni Berbaum | Speech-Language Pathologist | 4817 Elmley Pl Apt 315, Waldorf, MD 20602 | 2018-01-06 |
| 1891224853 | Linda E Smith | Social Worker | 605 Pst Office Road, #301, Waldorf, MD 20602 | 2017-06-05 |
| 1104373273 | Love Ngum Che | Pharmacist | 25 Smallwood Village, Waldorf, MD 20602 | 2016-09-07 |
| 1639543341 | Matengy Toure | Pharmacist | 129 St Charles Pkwy, Waldorf, MD 20602 | 2015-11-18 |
| Find all providers in zip 20602 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356831440 | Advanced Pain Management, LLC | Clinic/Center | 11637 Terrace Dr Ste 101, Waldorf, MD 20602-3707 | 2018-05-14 |
| 1790062636 | Bay Surgery Centers - Waldorf, LLC | Clinic/Center | 2960 Technology Pl Ste 103a, Waldorf, MD 20601-4968 | 2011-11-07 |
| 1447580394 | Advanced Pain Surgery Center LLC | Clinic/Center | 12070 Old Line Ctr Ste 205, Waldorf, MD 20602-2567 | 2009-12-28 |
| 1114168192 | Luxxery Corporation of Maryland | Clinic/Center | 3010 Crain Hwy, Suite 400, Waldorf, MD 20601-2801 | 2009-03-20 |
| 1912993700 | Pembrooke Square Surgery Center, LLC | Clinic/Center | 11370 Pembrooke Sq, Waldorf, MD 20603-4842 | 2005-09-27 |
| 1588962831 | Asc Development Company, LLC | Clinic/Center | 3460 Old Washington Rd, Ste 300, Waldorf, MD 20602-3240 | 2011-03-10 |
| 1386949246 | Cambridge Womens Ambulatory Surgery Center, L.L.C. | Clinic/Center | 3500 Old Washington Rd, Suite 302, Waldorf, MD 20602-3224 | 2011-01-24 |
| 1518090406 | Hotchkiss Surgical Center, LLC | Clinic/Center | 12070 Old Line Ctr, Suite 110, Waldorf, MD 20602-2513 | 2007-03-13 |
| 1902984321 | Civista Partners Ambulatory Surgery Center | Clinic/Center | 3510 Old Washington Rd, Suite 200, Waldorf, MD 20602-3233 | 2006-11-02 |
| 1003889379 | The Waldorf Endoscopy Asc, LLC | Clinic/Center | 3510 Old Washington Rd, Waldorf, MD 20602-3233 | 2006-02-08 |
| Find all providers in WALDORF | ||||
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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.