Provider Demographics
NPI:1083701742
Name:ARUNDEL AMBULATORY SURGERY CENTER, INC.
Entity type:Organization
Organization Name:ARUNDEL AMBULATORY SURGERY CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:KLEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-573-9191
Mailing Address - Street 1:621 RIDGELY AVE
Mailing Address - Street 2:SUITE 401
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-1081
Mailing Address - Country:US
Mailing Address - Phone:410-224-2811
Mailing Address - Fax:410-224-6971
Practice Address - Street 1:621 RIDGELY AVE
Practice Address - Street 2:SUITE 401
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-1081
Practice Address - Country:US
Practice Address - Phone:410-224-2811
Practice Address - Fax:410-224-6971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA1067261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDZZ47Medicare PIN
MDD65467Medicare UPIN
MDI40788Medicare UPIN
MDD05906Medicare UPIN