Healthcare Provider Details

I. General information

NPI: 1366486508
Provider Name (Legal Business Name): MID-ATLANTIC ANESTHESIA ASSOCIATES PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 10/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 HADDON AVE
CAMDEN NJ
08103-3101
US

IV. Provider business mailing address

PO BOX 8505
CHERRY HILL NJ
08002-0505
US

V. Phone/Fax

Practice location:
  • Phone: 856-757-3836
  • Fax:
Mailing address:
  • Phone: 856-755-1616
  • Fax: 856-755-0098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES M ARMSTRONG
Title or Position: DIRECTOR
Credential: M.D.
Phone: 856-757-3836