ADVANTIA SURGICAL LLC NPI 1245620871

NPI Information

  • NPI: 1245620871
  • Provider Name: ADVANTIA SURGICAL LLC
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • Doing Business As: ADVANTIA HEALTH INDIAN CREEK ASC
  • Address: 12240 INDIAN CREEK CT STE 130
    BELTSVILLE, MD
    ZIP 20705
  • Phone: (240) 560-5092

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NPI Details

ADVANTIA SURGICAL LLC is an ambulatory surgical clinic center in Beltsville, MD. ADVANTIA SURGICAL LLC NPI is 1245620871. The provider is registered as an organization entity type.
The provider Is Doing Business As Advantia Health Indian Creek Asc.

The provider's business location address is:

12240 INDIAN CREEK CT STE 130
BELTSVILLE, MD
ZIP 20705-260
Phone: (240) 560-5092

The provider's authorized official is Peter Glass .
The authorized official title is Chief Medical Officer and has the following contact phone number (240) 560-5092.

The enumeration date for this NPI number is 2/3/2015 and was last updated on 6/28/2017.

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

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
121C001572MEDICARE OSCAR/CERTIFICATIONMARYLAND
2A1572OTHERMARYLANDMD STATE ASC LICENSE
3582166OTHERMARYLANDTHE JOINT COMMISSION CERTIFICATION
4454377MEDICARE PINMARYLAND

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: 3/30/2025

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