Healthcare Provider Details

I. General information

NPI: 1528208964
Provider Name (Legal Business Name): METROPOLITAN ANESTHESIA CONSULTANTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2009
Last Update Date: 03/10/2025
Certification Date: 03/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19455 DEERFIELD AVE STE 212
LANSDOWNE VA
20176-8102
US

IV. Provider business mailing address

ONE GI CREDENTIALING DEPARTMENT PO BOX 381468
GERMANTOWN TN
38183-1468
US

V. Phone/Fax

Practice location:
  • Phone: 703-723-6322
  • Fax: 703-723-8336
Mailing address:
  • Phone:
  • 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: AIMEE CATHLEEN JUDY
Title or Position: DIRECTOR, CREDENTIALING
Credential:
Phone: 901-737-4665