Provider Demographics
NPI:1104639509
Name:NSPC SURGERY CENTER OF FREDERICK, LLC
Entity type:Organization
Organization Name:NSPC SURGERY CENTER OF FREDERICK, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:YESHVANT
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVALGUND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:855-836-7246
Mailing Address - Street 1:5280 CORPORATE DR STE C250
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-8508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:75 THOMAS JOHNSON DR STE C
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4895
Practice Address - Country:US
Practice Address - Phone:301-620-0012
Practice Address - Fax:301-620-9687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical