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General NPI Number Information
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NPI Number | 1295199925
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Entity Type | Organization
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Legal Business Name | WALDORF ANESTHESIA SERVICES LLC
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Dates
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Enumeration Date | 04/08/2016
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Last Update Date | 04/08/2016
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Provider Practice Location Address
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Address Line | 3510 OLD WASHINGTON RD STE 200
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City | WALDORF
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State | MD
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Zip | 20602-3233
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Country | US
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Telephone | 301-861-3660
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Fax | 301-843-5184
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Provider Business Mailing Address
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Address Line | PO BOX 826894
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City | PHILADELPHIA
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State | PA
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Zip | 19182-6894
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Country | US
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Telephone | 941-360-1566
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Fax | 941-358-9818
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Authorized Official
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Title or Position | MEMBER
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Name | MR. JOSEPH R. MURPHY
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Credential |
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Telephone | 941-360-1566
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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 | MD
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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 | MD
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