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General NPI Number Information
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NPI Number | 1720223209
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Entity Type | Organization
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Legal Business Name | SPECTRUM ANESTHESIA SERVICES LLC
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Dates
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Enumeration Date | 12/11/2008
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Last Update Date | 05/04/2009
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Provider Practice Location Address
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Address Line | 6802 PARAGON PL SUITE 410
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City | RICHMOND
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State | VA
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Zip | 23230-1644
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Country | US
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Telephone | 703-295-9360
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Fax | 703-295-9369
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Provider Business Mailing Address
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Address Line | PO BOX 37158
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City | BALTIMORE
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State | MD
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Zip | 21297-3158
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Country | US
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Telephone | 703-295-9360
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Fax | 703-295-9369
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | NINA DUGGAN
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Credential |
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Telephone | 703-295-9360
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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 | VA
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