MIVC ASC, LLC – NPI #1174074538
Clinic/Center

MIVC ASC, LLC is an AHC clinic located in LAUREL, MD. NPPES has assigned the NPI number 1174074538 to MIVC ASC, LLC on October 20, 2016. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 10 years ago on Nov 02, 2016. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MIVC ASC, LLC below.

NPI Profile for
MIVC ASC, LLC

NPI Number
1174074538
Enumeration Date

(more than 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
MIVC ASC, LLC
Primary location
9201 CHERRY LANE
LAUREL, MD 20707
Phone: (301) 497-1590 Fax:
Mailing address
8730 CHERRY LN
SUITE 10
LAUREL, MD 20707-6212
Phone: (301) 497-1590 Fax:
Organization Subpart
Yes - MIVC ASC, LLC is subpart of another organization.
Authorized Official
JEFFERY DORMU
CEO/VASCULAR SURGEON
Phone: (301) 497-1590
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.