MEDICARE: CGI ANESTHESIA ASSOCIATES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician		OH
2	367500000X	Certified Registered Nurse Anesthetist

General Provider Information

NPI Number	:	1174914352
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CGI ANESTHESIA ASSOCIATES LLC

Provider Business Mailing Address
First Line	:	5127 HIGHWAY 17 SOUTH
Second Line	:
City	:	MURRELLS INLET
State	:	SC
Zip	:	29576-5045
Country	:	US
Telephone Number	:	843-651-2624
Fax Number	:	843-491-4023

Provider Business Practice Location Address
First Line	:	4746 MONTGOMERY RD
Second Line	:	SUITE 202
City	:	CINCINNATI
State	:	OH
Zip	:	45212-2622
Country	:	US
Telephone Number	:	513-451-6001
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. DAVID D HESS
Credential	:	M.D.
Telephone Number	:	513-451-6001

Provider Enumeration Date	:	02/10/2015
Last Update Date	:	03/12/2015

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