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General NPI Number Information
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NPI Number | 1356745046
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Entity Type | Organization
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Legal Business Name | PINNACLE MID-ATLANTIC ANESTHESIA ASSOCIATES PC
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 09/11/2019
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Provider Practice Location Address
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Address Line | 100 WITMER RD STE 220
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City | HORSHAM
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State | PA
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Zip | 19044-2251
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Country | US
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Telephone | 215-442-5080
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Fax | 877-329-2370
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Provider Business Mailing Address
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Address Line | 13737 NOEL RD STE 1600
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City | DALLAS
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State | TX
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Zip | 75240-1331
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Country | US
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Telephone | 954-838-2371
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL R HICKS
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Credential | MD
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Telephone | 954-838-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (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 | 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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