MEDICARE: SYLVA ANESTHESIOLOGY, PA

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	174400000X	Specialist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CM3416	OTHER	NC	RAILROAD MEDICARE PROV #

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417900986
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYLVA ANESTHESIOLOGY, PA

Provider Business Mailing Address
First Line	:	PO BOX 235022
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36123-5022
Country	:	US
Telephone Number	:	334-386-2054
Fax Number	:	334-244-1830

Provider Business Practice Location Address
First Line	:	59 HOSPITAL RD
Second Line	:
City	:	SYLVA
State	:	NC
Zip	:	28779-2732
Country	:	US
Telephone Number	:	334-386-2054
Fax Number	:	334-244-1830

Authorized Official
Title or Position	:	ACCOUNT MANAGER
Name	:	TERRIE L. CARLETON
Credential	:
Telephone Number	:	334-386-2054

Provider Enumeration Date	:	05/18/2006
Last Update Date	:	10/09/2008

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