=====================================================
General NPI Number Information
=====================================================
NPI Number | 1518704378
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CAPITAL CARE ANESTHESIA LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/10/2024
-----------------------------------------------------
Last Update Date | 07/18/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4660 WILKENS AVE STE 208
-----------------------------------------------------
City | BALTIMORE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21229-4848
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-274-2900
-----------------------------------------------------
Fax | 443-274-2589
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1403 PADDOCKS CT
-----------------------------------------------------
City | CROWNSVILLE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21032-1453
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-274-2900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ROBERT ZAREMSKI
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 443-274-2900
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------