MD Laser Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

A1546 Issued in MD

Legal business name

MD LASER SURGERY CENTER, LLC

Practice address

7120 Minstrel Way
Suite 103
Columbia, MD 21045-5248

Phone

(410) 312-5248

Fax

(443) 283-0399

NPI assigned

Mar 4, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Clement S. K. Banda, MDNPI 1255385498

Title

Owner

Phone

(443) 283-0600

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

MD Laser Surgery CenterCCN 21C0001546

Medicare certification status

ActiveFrom the Provider of Services file

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Clement S. K. Banda, M.D.

  • Dermatology Physician
  • Columbia, MD
  • NPI 1255385498
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758240000000",
    "number": "1346581105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7120 MINSTREL WAY STE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455274",
            "telephone_number": "410-312-5248",
            "fax_number": "443-283-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7120 MINSTREL WAY",
            "address_2": "SUITE 103",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455248",
            "telephone_number": "410-312-5248",
            "fax_number": "443-283-0399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD LASER SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A",
        "authorized_official_last_name": "BANDA",
        "authorized_official_first_name": "CLEMENT",
        "authorized_official_middle_name": "S. K.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-283-0600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1546",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOINT COMMISSION ACCR. ORG. ID",
            "identifier": "549651",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "A1546",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Au'Bryone Dynelle McQueen
• Renee McSwain
• Jack W McWatters, MD
• Douglas McWilliams, MD
• MD Laser Medicine and Surgery Inc
• MD Oms SDS, LLC
• MD Pain Relief Center, LLC
• MD Specialty Dental Services, LLC
• MD Specialty Dental Services, LLC
• Nathan Mead

• Ambulatory Surgical Clinic/Center in Columbia, MD
• Providers in Columbia, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.