Healthcare Provider Details

I. General information

NPI: 1396761573
Provider Name (Legal Business Name): WEST END ANESTHESIA GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 12/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 BREMO RD. STE 100
RICHMOND VA
23226
US

IV. Provider business mailing address

5855 BREMO RD. STE. 100
RICHMOND VA
23226
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-6258
  • Fax: 804-673-1038
Mailing address:
  • Phone: 804-288-6258
  • Fax: 804-673-1038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. JOSHUA R WEISS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 804-288-6258