Healthcare Provider Details
I. General information
NPI: 1548482060
Provider Name (Legal Business Name): AMSOL ANESTHETISTS OF DUNN NC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2007
Last Update Date: 08/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
800 TILGHMAN DR
DUNN NC
28334-5510
US
IV. Provider business mailing address
PO BOX 2644
BIRMINGHAM AL
35202-2644
US
V. Phone/Fax
- Phone: 910-892-7161
- Fax:
- Phone: 205-322-1808
- Fax: 205-322-1851
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 367500000X |
| Taxonomy | Certified Registered Nurse Anesthetist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALAN
DALE
HILLIARD
Title or Position: CFO
Credential:
Phone: 336-688-7011