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General NPI Number Information
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NPI Number | 1336126150
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Entity Type | Organization
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Legal Business Name | BETHESDA ANESTHESIA ASSOC LLC
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Dates
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Enumeration Date | 12/22/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5110 RIDGEFIELD RD
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City | BETHESDA
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State | MD
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Zip | 20816-3346
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Country | US
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Telephone | 640-355-6700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 79416
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City | BALTIMORE
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State | MD
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Zip | 21279-0416
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Country | US
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Telephone | 240-355-6200
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Fax | 301-320-0374
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Authorized Official
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Title or Position | CEO
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Name | DR. MARK G SCHUTZ
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Credential | MD
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Telephone | 240-355-6700
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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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