Healthcare Provider Details

I. General information

NPI: 1306466123
Provider Name (Legal Business Name): SHENANDOAH ANESTHESIA & RESEARCH SERVICES , PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2020
Last Update Date: 07/22/2021
Certification Date: 07/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

541 SUNSET LN STE 201
CULPEPER VA
22701-3979
US

IV. Provider business mailing address

1912 SEPTEMBER CT
CULPEPER VA
22701-3313
US

V. Phone/Fax

Practice location:
  • Phone: 888-276-1910
  • Fax: 540-829-8191
Mailing address:
  • Phone: 888-276-1910
  • Fax:

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: KHALID ATHAR
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 888-276-1910