Healthcare Provider Details
I. General information
NPI: 1750218830
Provider Name (Legal Business Name): GUIDANT ANESTHESIA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14122 ALFALFA FIELD CT
BOWIE MD
20720-5843
US
IV. Provider business mailing address
14122 ALFALFA FIELD CT
BOWIE MD
20720-5843
US
V. Phone/Fax
- Phone: 610-597-5134
- Fax:
- Phone: 610-597-5134
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
VICTORIA
LADELE
Title or Position: CEO
Credential: CRNA
Phone: 803-474-3000