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General NPI Number Information
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NPI Number | 1225781297
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Entity Type | Organization
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Legal Business Name | POTOMAC ANESTHESIA CONSULTANTS LLC
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Dates
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Enumeration Date | 01/31/2022
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Last Update Date | 10/17/2022
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Provider Practice Location Address
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Address Line | 15001 SHADY GROVE RD STE 400
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City | ROCKVILLE
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State | MD
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Zip | 20850-6320
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Country | US
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Telephone | 781-915-0222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 49026
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City | BALTIMORE
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State | MD
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Zip | 21297-4926
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Country | US
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Telephone | 240-388-6922
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | LAWRENCE BASSIN
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Credential | MD
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Telephone | 240-388-6922
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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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