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General NPI Number Information
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NPI Number | 1275855637
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Entity Type | Organization
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Legal Business Name | MERIDIAN ANESTHESIA SERVICES, LLC
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Dates
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Enumeration Date | 02/25/2010
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Last Update Date | 02/25/2010
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Provider Practice Location Address
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Address Line | 11370 PEMBROOKE SQ
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City | WALDORF
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State | MD
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Zip | 20603-4842
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Country | US
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Telephone | 410-610-3608
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Fax |
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Provider Business Mailing Address
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Address Line | 7590 N FLINT HILL RD
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City | OWINGS
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State | MD
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Zip | 20736-4318
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Country | US
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Telephone | 410-610-3608
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF SERVICES
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Name | RALPH W TORR
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Credential | M.D.
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Telephone | 410-610-3608
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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 | D0051726
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License Number State | MD
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