Healthcare Provider Details

I. General information

NPI: 1831957786
Provider Name (Legal Business Name): ML ANESTHESIA PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2024
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1902 W UNION HILLS DR # 41340
PHOENIX AZ
85027-5984
US

IV. Provider business mailing address

1902 W UNION HILLS DR # 41340
PHOENIX AZ
85027-5984
US

V. Phone/Fax

Practice location:
  • Phone: 623-320-0660
  • Fax:
Mailing address:
  • Phone: 623-320-0660
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: ELYSSA FISCHER
Title or Position: BILLER
Credential:
Phone: 623-320-0660