Healthcare Provider Details

I. General information

NPI: 1487606075
Provider Name (Legal Business Name): MARTIN COUNTY ANESTHESIA GROUP PL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 10/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE HOSPITAL AVE
STUART FL
34994-2346
US

IV. Provider business mailing address

75 REMITTANCE DR SUITE 6634
CHICAGO IL
60675-6634
US

V. Phone/Fax

Practice location:
  • Phone: 772-287-5200
  • Fax: 866-665-2702
Mailing address:
  • Phone: 877-538-4594
  • Fax: 866-665-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. GEORGE E MCLAIN
Title or Position: PRESIDENT
Credential: MD
Phone: 772-287-5200