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General NPI Number Information
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NPI Number | 1194775239
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Entity Type | Organization
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Legal Business Name | OBSTETRIC ANESTHESIA CONSULTANTS PSC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 09/06/2008
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Provider Practice Location Address
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Address Line | 200 E CHESTNUT ST
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City | LOUISVILLE
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State | KY
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Zip | 40202-1831
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Country | US
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Telephone | 502-629-2880
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Fax |
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Provider Business Mailing Address
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Address Line | 3217 RELIABLE PKWY
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City | CHICAGO
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State | IL
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Zip | 60686-0001
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Country | US
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Telephone | 706-650-0705
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Fax |
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Authorized Official
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Title or Position | HEAD OF GROUP
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Name | MUSHTAQUE JUNEJA
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Credential | MD
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Telephone | 502-629-2880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #2
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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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