Provider Demographics
NPI:1972869881
Name:ADVANCED SURGERY CENTER OF BETHESDA, LLC
Entity type:Organization
Organization Name:ADVANCED SURGERY CENTER OF BETHESDA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-609-1168
Mailing Address - Street 1:6430 ROCKLEDGE DR
Mailing Address - Street 2:# 160
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1805
Mailing Address - Country:US
Mailing Address - Phone:301-312-6144
Mailing Address - Fax:301-312-6171
Practice Address - Street 1:6430 ROCKLEDGE DR
Practice Address - Street 2:# 160
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1805
Practice Address - Country:US
Practice Address - Phone:301-312-6144
Practice Address - Fax:301-312-6171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-04
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical