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General NPI Number Information
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NPI Number | 1245647098
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Entity Type | Organization
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Legal Business Name | EPIX ANESTHESIA OF COLUMBUS LLC
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Dates
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Enumeration Date | 07/14/2014
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Last Update Date | 07/14/2014
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Provider Practice Location Address
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Address Line | 3949 HOLCOMB BRIDGE RD STE 300
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City | PEACHTREE CORNERS
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State | GA
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Zip | 30092-2208
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Country | US
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Telephone | 678-580-1349
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Fax |
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Provider Business Mailing Address
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Address Line | 1430 S HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43207-1045
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | M. FARID EDWARDS
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Credential | MD
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Telephone | 678-580-1349
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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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Taxonomy #2
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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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