Healthcare Provider Details

I. General information

NPI: 1174914352
Provider Name (Legal Business Name): CGI ANESTHESIA ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2015
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4746 MONTGOMERY RD SUITE 202
CINCINNATI OH
45212-2622
US

IV. Provider business mailing address

5127 HIGHWAY 17 SOUTH
MURRELLS INLET SC
29576-5045
US

V. Phone/Fax

Practice location:
  • Phone: 513-451-6001
  • Fax:
Mailing address:
  • Phone: 843-651-2624
  • Fax: 843-491-4023

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID D HESS
Title or Position: MANAGING MEMBER
Credential: M.D.
Phone: 513-451-6001