MEDICARE: PROFESSIONAL ANESTHESIA CONSULTANTS, PC

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		PA
2	207L00000X	Anesthesiology Physician	C1-0006506	DE
3	207L00000X	Anesthesiology Physician	25MA04290400	NJ
4	207L00000X	Anesthesiology Physician	MD043052E	PA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841273869
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL ANESTHESIA CONSULTANTS, PC

Provider Business Mailing Address
First Line	:	4330 E WEST HWY
Second Line	:	SUITE 1100
City	:	BETHESDA
State	:	MD
Zip	:	20814-4408
Country	:	US
Telephone Number	:	301-986-8010
Fax Number	:	301-986-8011

Provider Business Practice Location Address
First Line	:	4330 E WEST HWY
Second Line	:	SUITE 1100
City	:	BETHESDA
State	:	MD
Zip	:	20814-4408
Country	:	US
Telephone Number	:	301-986-8010
Fax Number	:	301-986-8011

Authorized Official
Title or Position	:	CEO
Name	:	JOHN R WALTON
Credential	:
Telephone Number	:	301-986-8010

Provider Enumeration Date	:	11/23/2005
Last Update Date	:	02/23/2015

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Directions to “PROFESSIONAL ANESTHESIA CONSULTANTS, PC ” Practice Location

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