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General NPI Number Information
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NPI Number | 1588898548
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Entity Type | Organization
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Legal Business Name | OHIO SURGICAL ANESTHESIA LLC
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Dates
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Enumeration Date | 05/06/2009
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Last Update Date | 10/31/2016
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Provider Practice Location Address
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Address Line | 5319 HOAG DR ROOM 1
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City | SHEFFIELD VILLAGE
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State | OH
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Zip | 44035-1494
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Country | US
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Telephone | 855-600-5161
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Fax | 706-650-1034
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Provider Business Mailing Address
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Address Line | PO BOX 310407
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City | DES MOINES
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State | IA
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Zip | 50331-0407
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Country | US
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Telephone | 800-394-4445
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Fax | 706-650-1034
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ANDREW RIBAUDO
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Credential |
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Telephone | 404-217-2659
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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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