Shady Grove Surgery Center LLC
Obstetrics & Gynecology in Gaithersburg, MD. Organization (NPI-2).
NPI number1194222620
StatusActive
Last updated in NPPESDec 5, 2025
Details
- NPI
- 1194222620
- Entity type
- Organization (NPI-2)
- Legal business name
- Shady Grove Surgery Center LLC
- Organization subpart
- No
- Enumeration date
- Apr 11, 2018
- Certification date
- Dec 5, 2025
- Last updated
- Dec 5, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207V00000X | Obstetrics & Gynecology | – | – | Yes |
Practice location
10810 Darnestown Rd Ste 202Gaithersburg, MD 20878-2601
Phone 240-912-4546 · Fax 240-912-4471
Mailing address
10810 Darnestown Rd Ste 202Gaithersburg, MD 20878-2601
Phone 240-912-4546 · Fax 240-912-4471
Authorized official
Shabnam Dadgar
MD
2409124546
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