Provider Demographics
NPI:1225871478
Name:AMBER MEADOW SURGICAL CENTER, LLC
Entity type:Organization
Organization Name:AMBER MEADOW SURGICAL CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HASEEBUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-606-0551
Mailing Address - Street 1:186 THOMAS JOHNSON DR STE 104
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4471
Mailing Address - Country:US
Mailing Address - Phone:301-606-0551
Mailing Address - Fax:301-606-1958
Practice Address - Street 1:186 THOMAS JOHNSON DR STE 104
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4471
Practice Address - Country:US
Practice Address - Phone:301-606-0551
Practice Address - Fax:301-606-1958
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMBER MEADOW SURGERY CENTER, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-06-17
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical