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General NPI Number Information
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NPI Number | 1366431132
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Entity Type | Organization
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Legal Business Name | GRANT ANESTHESIA SERVICES LTD
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Dates
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Enumeration Date | 10/14/2005
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Last Update Date | 09/24/2009
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Provider Practice Location Address
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Address Line | 111 S GRANT AVE 3RD FL
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City | COLUMBUS
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State | OH
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Zip | 43215-4701
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Country | US
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Telephone | 614-566-8808
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Fax |
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Provider Business Mailing Address
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Address Line | 5350 FRANTZ RD
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City | DUBLIN
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State | OH
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Zip | 43016-4259
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Country | US
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Telephone | 614-544-6355
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Fax | 614-544-6350
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Authorized Official
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Title or Position | REV CYCLE DIRECTOR
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Name | MR. MARK WUESTEWALD
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Credential |
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Telephone | 614-566-5107
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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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