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General NPI Number Information
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NPI Number | 1124575592
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Entity Type | Organization
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Legal Business Name | SHERIDAN ANESTHESIA SERVICES OF VIRGINIA, INC
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Dates
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Enumeration Date | 09/02/2016
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Last Update Date | 09/18/2019
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Provider Practice Location Address
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Address Line | 600 W RIDGE RD
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City | WYTHEVILLE
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State | VA
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Zip | 24382-1044
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Country | US
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Telephone | 276-228-0200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 452498
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City | SUNRISE
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State | FL
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Zip | 33345-2498
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Country | US
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Telephone | 954-838-2371
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KATHLEEN KONDAS
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Credential |
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Telephone | 954-838-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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