Healthcare Provider Details

I. General information

NPI: 1861628448
Provider Name (Legal Business Name): ANESTHESIA PROVIDERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2009
Last Update Date: 06/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 BEISER BLVD SUITE 201E
DOVER DE
19904-8208
US

IV. Provider business mailing address

240 BEISER BLVD SUITE 201E
DOVER DE
19904-8208
US

V. Phone/Fax

Practice location:
  • Phone: 302-734-7246
  • Fax: 302-678-8890
Mailing address:
  • Phone: 302-734-7246
  • Fax: 302-678-8890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GANESH R BALU
Title or Position: CEO
Credential: MD
Phone: 302-741-0111