Healthcare Provider Details

I. General information

NPI: 1285717587
Provider Name (Legal Business Name): MIDWEST ANESTHESIA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 N NEW BALLAS RD
SAINT LOUIS MO
63141-6835
US

IV. Provider business mailing address

PO BOX 822344
PHILADELPHIA PA
19182-2344
US

V. Phone/Fax

Practice location:
  • Phone: 908-653-9399
  • Fax:
Mailing address:
  • Phone: 908-653-9399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. STEPHEN BELL
Title or Position: ANESTHESIOLOGIST
Credential: MD
Phone: 908-653-9399