MLK Surgery Center Inc

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MLK SURGERY CENTER INC

Practice address

312 Martin Luther King Jr Blvd Ste 102
Baltimore, MD 21201-1221

Phone

(410) 777-8971

Fax

(877) 595-7180

NPI assigned

Nov 23, 2018

Organization subpart

No

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

Authorized official

Name

Ritu Bhambhani, MD

Title

Owner

Phone

(443) 857-1416

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1542931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542931200000",
    "number": "1508335340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WALTER WARD BLVD STE 200",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091285",
            "telephone_number": "443-857-1416",
            "fax_number": "877-595-7180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 MARTIN LUTHER KING JR BLVD STE 102",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011221",
            "telephone_number": "410-777-8971",
            "fax_number": "877-595-7180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLK SURGERY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-23",
        "last_updated": "2018-11-23",
        "status": "A",
        "authorized_official_last_name": "BHAMBHANI",
        "authorized_official_first_name": "RITU",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-857-1416",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Mixter, M.D.
• Shahida Binti Mizan, MD
• Shannon Mize
• Alix Mizoue, MD
• MJD Chiropractic LLC
• MMBR Behavioral Health Services Inc.
• MNK Community Resources, LLC
• MNK Community Resources, LLC
• MNK Rehabilitation & Psychological Services, Inc.
• MNR Industries LLC

• Ambulatory Surgical Clinic/Center in Baltimore, MD
• Providers in Baltimore, 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 Nov 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.