Healthcare Provider Details

I. General information

NPI: 1952117301
Provider Name (Legal Business Name): BTR ANESTHESIA, CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8320 OLD COURTHOUSE RD STE 401
VIENNA VA
22182-3848
US

IV. Provider business mailing address

3241 GREENVILLE HWY
FLAT ROCK NC
28731-9587
US

V. Phone/Fax

Practice location:
  • Phone: 513-600-1607
  • Fax:
Mailing address:
  • Phone: 513-600-1607
  • 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: LINDSEY NELSON
Title or Position: OWNER
Credential: MD
Phone: 513-600-1607