Provider Demographics
NPI:1124492996
Name:MOHS AND SKIN SURGERY CENTER, LLC
Entity type:Organization
Organization Name:MOHS AND SKIN SURGERY CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAIF
Authorized Official - Middle Name:
Authorized Official - Last Name:SYED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-252-9090
Mailing Address - Street 1:1447 YORK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-6017
Mailing Address - Country:US
Mailing Address - Phone:410-252-9090
Mailing Address - Fax:410-494-7064
Practice Address - Street 1:1447 YORK RD
Practice Address - Street 2:SUITE 301
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6017
Practice Address - Country:US
Practice Address - Phone:410-252-9090
Practice Address - Fax:410-494-7064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical