Healthcare Provider Details

I. General information

NPI: 1245286434
Provider Name (Legal Business Name): FALLS ANESTHESIA ASSOCIATES, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

W180N8085 TOWN HALL RD
MENOMONEE FALLS WI
53051-3518
US

IV. Provider business mailing address

225 S EXECUTIVE DR
BROOKFIELD WI
53005-4266
US

V. Phone/Fax

Practice location:
  • Phone: 262-251-1000
  • Fax:
Mailing address:
  • Phone: 262-787-4026
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MAHESH BELANI
Title or Position: AUTHORIZED OFFICIAL
Credential: M.D.
Phone: 262-251-1000