NEWBRIDGE SURGERY CENTER AT WALDORF – NPI #1710112669
Clinic/Center

NEWBRIDGE SURGERY CENTER AT WALDORF is an AHC clinic located in WALDORF, MD. NPPES has assigned the NPI number 1710112669 to NEWBRIDGE SURGERY CENTER AT WALDORF on May 21, 2009. 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 last updated on Apr 04, 2025. 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 NEWBRIDGE SURGERY CENTER AT WALDORF below.

NPI Profile for
NEWBRIDGE SURGERY CENTER AT WALDORF

NPI Number
1710112669
Enumeration Date

(more than 17 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
NEWBRIDGE SURGERY CENTER AT WALDORF
Primary location
3581 OLD WASHINGTON ROAD
SUITE G
WALDORF, MD 20602
Phone: (301) 638-4400 Fax: (301) 638-2200
Mailing address
196 THOMAS JOHNSON DR
SUITE 215
FREDERICK, MD 21702-4397
Phone: (301) 668-9988 Fax: (301) 668-9977
Organization Subpart
No
Authorized Official
MRUTHYUNJAYA GONCHIGAR
OWNER/PHYSICIAN
Phone: (301) 668-9988
Updated
Certification Date
Apr 04, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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.