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General NPI Number Information
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NPI Number | 1376501007
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Entity Type | Organization
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Legal Business Name | HOLY CROSS ANESTHESIOLOGY ASSOCIATE PA
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 11/27/2024
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Provider Practice Location Address
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Address Line | 4000 BLACKBURN LN STE 220
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City | BURTONSVILLE
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State | MD
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Zip | 20866-1104
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Country | US
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Telephone | 301-770-8700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 64605
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City | BALTIMORE
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State | MD
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Zip | 21264
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Country | US
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Telephone | 301-933-8554
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SARA DEPEW
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Credential | MD
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Telephone | 347-731-2133
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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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