Healthcare Provider Details

I. General information

NPI: 1861702425
Provider Name (Legal Business Name): SOUTHEAST ANESTHESIOLOGY CONSULTANTS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2010
Last Update Date: 07/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 GREEN VALLEY ROAD SUITE 304
GREENSBORO NC
27408
US

IV. Provider business mailing address

1500 CONCORD TER
SUNRISE FL
33323-2815
US

V. Phone/Fax

Practice location:
  • Phone: 336-282-4840
  • Fax: 336-282-4660
Mailing address:
  • Phone: 800-243-3839
  • Fax: 844-686-2961

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. JOSHUA MILLER
Title or Position: PRESIDENT
Credential: MD
Phone: 954-384-0175