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General NPI Number Information
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NPI Number | 1689990871
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Entity Type | Organization
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Legal Business Name | AMBULATORY ANESTHESIA OF NORTHWEST INDIANA, LLC
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Dates
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Enumeration Date | 04/13/2010
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Last Update Date | 04/13/2010
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Provider Practice Location Address
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Address Line | 1101 GLENDALE BLVD SUITE 102
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City | VALPARAISO
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State | IN
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Zip | 46383-3767
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Country | US
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Telephone | 219-462-6144
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Fax | 770-237-1492
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Provider Business Mailing Address
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Address Line | 7 PARKWAY CTR SUITE 375
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City | PITTSBURGH
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State | PA
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Zip | 15220-3704
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Country | US
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Telephone | 412-937-5947
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Fax | 770-237-1492
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN J MURPHY
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Credential | MD
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Telephone | 412-937-5947
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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 | IN
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