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General NPI Number Information
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NPI Number | 1588907075
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Entity Type | Organization
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Legal Business Name | ANESTHESIOLOGY PAIN MANAGEMENT INC
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Dates
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Enumeration Date | 04/03/2013
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Last Update Date | 04/03/2013
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Provider Practice Location Address
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Address Line | 5307 LIMESTONE RD SUITE 103
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City | WILMINGTON
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State | DE
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Zip | 19808-1275
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Country | US
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Telephone | 302-283-3300
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Fax | 302-283-3321
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Provider Business Mailing Address
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Address Line | 71 OMEGA DR BUILDING D
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City | NEWARK
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State | DE
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Zip | 19713-2063
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Country | US
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Telephone | 302-283-3300
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Fax | 302-283-3321
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Authorized Official
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Title or Position | CREDENTIALING SUPERVISOR
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Name | JOHN B MAYES
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Credential |
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Telephone | 302-283-3300
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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 | C1-0009919
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License Number State | DE
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