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General NPI Number Information
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NPI Number | 1932397544
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Entity Type | Organization
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Legal Business Name | CHILDREN'S ANESTHESIA GROUP INC
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 1 CHILDREN'S PLZ
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City | DAYTON
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State | OH
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Zip | 45404
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Country | US
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Telephone | 937-641-3350
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Fax | 937-641-6145
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Provider Business Mailing Address
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Address Line | 1 CHILDREN'S PLZ
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City | DAYTON
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State | OH
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Zip | 45404-1815
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Country | US
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Telephone | 937-641-3350
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Fax | 937-641-6145
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Authorized Official
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Title or Position | C.F.O.
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Name | MR. CHRIS BERGMAN
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Credential | CFO
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Telephone | 937-641-3338
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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 | OH
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State | OH
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Taxonomy #3
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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 | OH
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Taxonomy #4
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number |
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License Number State | OH
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