Healthcare Provider Details

I. General information

NPI: 1184700569
Provider Name (Legal Business Name): DANVILLE ANESTHESIOLOGISTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2006
Last Update Date: 10/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

142 S MAIN ST
DANVILLE VA
24541-2922
US

IV. Provider business mailing address

635 MAIN STREET JONES & ASSOCIATES
DANVILLE VA
24541
US

V. Phone/Fax

Practice location:
  • Phone: 434-799-2375
  • Fax:
Mailing address:
  • Phone: 434-793-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MUKESH NIGAM
Title or Position: PRESIDENT
Credential: MD
Phone: 434-799-2375