Healthcare Provider Details

I. General information

NPI: 1740218767
Provider Name (Legal Business Name): FIRST COLONIES ANESTHESIA ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9841 BROKEN LAND PKWY STE 310
COLUMBIA MD
21046-1169
US

IV. Provider business mailing address

12222 MERIT DR STE 600
DALLAS TX
75251-3294
US

V. Phone/Fax

Practice location:
  • Phone: 443-276-7624
  • Fax: 407-667-4338
Mailing address:
  • Phone: 407-667-0444
  • Fax: 407-667-4338

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number State

VIII. Authorized Official

Name: GRACE HILTON
Title or Position: MGR / PROVIDER ENROLLMENT
Credential:
Phone: 407-667-0444