Provider Demographics
NPI:1528152006
Name:CENTER FOR AMBULATORY SURGERY, INC,
Entity type:Organization
Organization Name:CENTER FOR AMBULATORY SURGERY, INC,
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HERON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-223-9040
Mailing Address - Street 1:1145 - 19TH STREET, NW
Mailing Address - Street 2:SUITE 850
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-0328
Mailing Address - Country:US
Mailing Address - Phone:202-223-9040
Mailing Address - Fax:202-223-9047
Practice Address - Street 1:1145 - 19TH STREET, NW
Practice Address - Street 2:SUITE 850
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-0328
Practice Address - Country:US
Practice Address - Phone:202-223-9040
Practice Address - Fax:202-223-9047
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEDSTAR SURGERY CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-02
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG01240Medicare ID - Type Unspecified