ADVANCED EYE LASER AND SURGERY CENTER NPI 1174329502

NPI Information

  • NPI: 1174329502
  • Provider Name: ADVANCED EYE LASER AND SURGERY CENTER
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 21D2328540
  • Address: 954 RIDGEBROOK RD STE 300
    SPARKS, MD
    ZIP 21152
  • Phone: (509) 379-3077

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NPI Details

ADVANCED EYE LASER AND SURGERY CENTER is an ambulatory surgical clinic center in Sparks, MD. ADVANCED EYE LASER AND SURGERY CENTER NPI is 1174329502. The provider is registered as an organization entity type.

The provider's business location address is:

954 RIDGEBROOK RD STE 300
SPARKS, MD
ZIP 21152-440
Phone: (509) 379-3077

The provider's authorized official is Steve Bowman .
The authorized official title is Administrator and has the following contact phone number (509) 379-3077.

The CLIA number assigned to this NPI record is 21D2328540 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/25/2025 and was last updated on 3/10/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes
2261QS0132XClinic/CenterOphthalmologic SurgeryNo

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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