Healthcare Provider Details

I. General information

NPI: 1821627951
Provider Name (Legal Business Name): BARNSTORMERS ANESTHESIA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2020
Last Update Date: 04/01/2020
Certification Date: 04/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2007 ROCK SPRING RD
FOREST HILL MD
21050-2620
US

IV. Provider business mailing address

2616 GUNPOWDER FARMS RD
FALLSTON MD
21047-2205
US

V. Phone/Fax

Practice location:
  • Phone: 410-879-4879
  • Fax:
Mailing address:
  • Phone: 970-250-2413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. STEVEN AMBROSICH
Title or Position: OWNER
Credential: MD
Phone: 970-250-2413