Healthcare Provider Details

I. General information

NPI: 1962790071
Provider Name (Legal Business Name): MARYLAND ANESTHESIA PROVIDERS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2011
Last Update Date: 06/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 RIDGELY AVE SUITE 101
ANNAPOLIS MD
21401-1081
US

IV. Provider business mailing address

621 RIDGELY AVE SUITE 101
ANNAPOLIS MD
21401-1081
US

V. Phone/Fax

Practice location:
  • Phone: 410-266-1588
  • Fax: 410-266-6931
Mailing address:
  • Phone: 410-266-1588
  • Fax: 410-266-6931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHAEL S EPSTEIN
Title or Position: OWNER/PHYSICIAN
Credential: M.D.
Phone: 410-266-1588