Basic Information
| Provider Information | |||||||||
| NPI: | 1578154514 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CLEARWAY SURGERY CENTER OF BEL AIR LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 201 DEFENSE HWY STE 205 | ||||||||
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| City: | ANNAPOLIS | ||||||||
| State: | MD | ||||||||
| PostalCode: | 214017096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8555277246 | ||||||||
| FaxNumber: | 8662295063 | ||||||||
| Practice Location | |||||||||
| Address1: | 602 S ATWOOD RD STE 103B | ||||||||
| Address2: | |||||||||
| City: | BEL AIR | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210144198 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8555277246 | ||||||||
| FaxNumber: | 8662295063 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/02/2021 | ||||||||
| LastUpdateDate: | 04/07/2021 | ||||||||
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| AuthorizedOfficialLastName: | CULLEN | ||||||||
| AuthorizedOfficialFirstName: | BRITNI | ||||||||
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| AuthorizedOfficialTitleorPosition: | SR. VICE PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4438379913 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 04/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.