Healthcare Provider Details

I. General information

NPI: 1598730251
Provider Name (Legal Business Name): HOWARD COUNTY ANESTHESIA ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 05/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11085 LITTLE PATUXENT PKWY SUITE 004
COLUMBIA MD
21044-2983
US

IV. Provider business mailing address

11085 LITTLE PATUXENT PKWY SUITE 004
COLUMBIA MD
21044-2983
US

V. Phone/Fax

Practice location:
  • Phone: 410-730-0099
  • Fax: 410-964-1345
Mailing address:
  • Phone: 410-730-0099
  • Fax: 410-964-1345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN C PAYNE II
Title or Position: PRESIDENT
Credential: M.D.
Phone: 410-730-0099