Healthcare Provider Details

I. General information

NPI: 1770801623
Provider Name (Legal Business Name): GATEWAY ANESTHESIA SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2010
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 BRAEBURN DR
SALEM VA
24153-7357
US

IV. Provider business mailing address

PO BOX 13766
ROANOKE VA
24037-3766
US

V. Phone/Fax

Practice location:
  • Phone: 540-772-3601
  • Fax: 540-776-6856
Mailing address:
  • Phone: 866-224-2413
  • Fax: 540-776-0699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JOHN J DANYI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 540-772-3601