Healthcare Provider Details

I. General information

NPI: 1710915715
Provider Name (Legal Business Name): AMERICAN ANESTHESIOLOGY OF SOUTH CAROLINA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 12/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 EAST CHEVES ST
FLORENCE SC
29506-2617
US

IV. Provider business mailing address

1500 CONCORD TERRACE 5TH FLOOR ATTN: MARIA GABBAI
SUNRISE FL
33323-2815
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-2000
  • Fax:
Mailing address:
  • Phone: 800-243-3839
  • Fax: 844-636-1410

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ERIC W. MASON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 800-243-3839